go back

Wisconsin rates for HCPCS Q4247

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

Facilitymedian $1,995 · 10th–90th $525–$4,2660%10%10th90th$1,995Professionalmedian $2,951 · 10th–90th $200–$3,1620%20%10th90th$2,951$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
$2,951.21 / $2,951.21 / $2,951.21
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
$323.59 / $676.08 / $1,174.90
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $1,096.48 / $1,905.46
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $223.87 / $676.08
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $2,951.21 / $4,466.84
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $1,348.96 / $2,398.83
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,235.94 / $3,235.94 / $5,011.87
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $60.26 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $562.34 / $562.34
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $302.00 / $1,071.52
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,162.28 / $4,265.80
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,162.28 / $16,595.87
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $147.91 / $147.91
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $870.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,290.87 / $2,290.87 / $8,317.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $1,230.27