go back

AMNIOREPAIR or AltiPly

Wisconsin rates for HCPCS Q4235

AMNIOREPAIR or AltiPly, per sq cm (add-on, list separately in addition to primary procedure)

Rates data updated July 2026.

Facilitymedian $155 · 10th–90th $83$4900%20%10th90th$155Professionalmedian $126 · 10th–90th $87$3630%20%10th90th$126$5.0$20.0$100.0$500.0$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$91.20
Median
$91.20
Typical High
$91.20
Aetna
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$91.20
Typical High
$97.72
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$239.88
Typical High
$446.68
Cigna
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$269.15
Typical High
$398.11
Cigna
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$125.89
Typical High
$223.87
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$87.10
Median
$91.20
Typical High
$199.53
DeanCare
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$104.71
Typical High
$104.71
Medica
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$83.18
Typical High
$199.53
Medica
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$81.28
Typical High
$169.82
Molina
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$60.26
Typical High
$85.11
Network Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$154.88
Typical High
$154.88
Network Health
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$100.00
Typical High
$162.18
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$87.10
Median
$91.20
Typical High
$199.53
Quartz
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$302.00
Typical High
$416.87
Quartz
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$489.78
Typical High
$707.95
Quartz
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$141.25
Typical High
$660.69
Security Health
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$117.49
Typical High
$144.54
United
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$295.12
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$151.36