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Missouri rates for HCPCS Q4247

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

Facilitymedian $2,042 · 10th–90th $129–$4,7860%10%10th90th$2,042Professionalmedian $2,951 · 10th–90th $110–$3,1620%20%40%10th90th$2,951$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$2,951.21 / $2,951.21 / $3,890.45
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,951.21 / $3,019.95 / $3,162.28
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $109.65 / $144.54
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $144.54 / $186.21
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $239.88 / $371.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $151.36
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $1,445.44 / $3,630.78
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,691.53 / $3,235.94 / $5,011.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $4,786.30 / $4,786.30
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $125.89 / $1,230.27