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Connecticut rates for HCPCS Q4247

AmnioText Patch, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,128.76 / $3,128.00 / $3,128.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,539.19 / $3,128.00 / $3,128.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$424.00 / $530.00 / $658.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,128.00 / $3,128.00 / $3,128.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,128.00 / $3,128.00 / $3,128.00
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.00 / $2,815.20 / $3,128.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,040.00 / $3,200.00 / $3,360.00