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Kansas rates for HCPCS Q4239

Amnio-Maxx or Amnio-Maxx Lite, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,663.67 / $2,663.67 / $2,663.67
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,902.62 / $1,940.67 / $2,663.67
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,794.93 / $1,794.93 / $1,902.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,902.62 / $1,902.62 / $1,902.62
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$399.74 / $2,079.27 / $3,110.76
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,038.50 / $2,038.50 / $10,260.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,902.62 / $1,902.62 / $2,525.71