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Minnesota 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
$3,680.00 / $3,680.00 / $3,680.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,944.00 / $3,054.40 / $3,680.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $1.00 / $3,128.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$530.00 / $2,971.60 / $3,128.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$810.68 / $1,489.75 / $2,093.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$545.40 / $633.60 / $685.80
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$720.00 / $1,365.26 / $1,886.98
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$540.00 / $540.00 / $576.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$530.00 / $530.00 / $1,667.50
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,200.00 / $3,200.00 / $5,800.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,200.00 / $3,200.00 / $5,800.96