go back

Oklahoma 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
$2,054.83 / $2,054.83 / $2,054.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,902.62 / $2,054.83 / $2,054.83
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
$2,140.42 / $2,311.66 / $3,130.17
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,997.43 / $2,038.50 / $10,260.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,828.42 / $1,902.62 / $2,108.10