go back

Wisconsin rates for HCPCS Q4239

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

Facilitymedian $2,291 · 10th–90th $1,905–$6,9180%20%10th90th$2,291Professionalmedian $1,905 · 10th–90th $115–$2,0890%20%40%10th90th$1,905$5.0$20.0$100.0$500.0$2.0K$10.0K

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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,949.84 / $1,949.84 / $1,949.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,905.46 / $2,089.30
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $114.82 / $269.15
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $5,128.61 / $8,912.51
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $223.87 / $3,019.95
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,949.84 / $4,265.80
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,089.30 / $4,466.84
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,041.74 / $4,265.80
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $60.26 / $85.11
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $72.44 / $72.44
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $223.87 / $446.68
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,290.87 / $8,128.31
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,137.96 / $9,549.93
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,570.40 / $2,570.40 / $3,162.28
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,344.23 / $5,495.41
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $2,344.23