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Kentucky 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
$2,944.00 / $2,944.00 / $2,944.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,944.00 / $2,944.00 / $3,054.40
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$530.00 / $530.00 / $576.32
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.11 / $1,144.80 / $55,999.44
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.51 / $76.48 / $47,249.53
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,212.09 / $1,212.09 / $3,128.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$530.00 / $3,128.00 / $3,128.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,000.00 / $3,000.00 / $3,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,880.00 / $3,200.00 / $3,296.00