go back

Utah rates for HCPCS Q4239

Amnio-maxx or lite per sq cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,207.04 / $2,207.04 / $2,207.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,902.62 / $2,092.88 / $2,378.28
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.42 / $2,737.88 / $5,591.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,902.62 / $1,902.62 / $1,902.62
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,883.59 / $2,092.88 / $2,092.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,902.62 / $1,902.62 / $1,902.62