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California rates for HCPCS Q4248

Dermacyte Amniotic Membrane Allograft, per sq cm (add-on, list separately in addition to primary procedure)

Facilitymedian $692 · 10th–90th $550$1,7780%20%40%10th90th$692Professionalmedian $550 · 10th–90th $126$2,6920%50%10th90th$550$0.1$2.0$50.0$1.0K$20.0K$500.0K

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
$549.54 / $562.34 / $4,786.30
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $549.54 / $4,265.80
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $691.83 / $1,778.28
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $602.56 / $2,570.40
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,456.54 / $6,456.54 / $6,456.54
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $1,584.89 / $3,235.94
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $218.78 / $295.12
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $154.88
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $549.54 / $741.31
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $165.96 / $275.42
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,943.28 / $7,943.28 / $7,943.28
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10,471.29 / $10,715.19 / $10,715.19
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $131.83 / $1,096.48
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $549.54 / $1,122.02
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $1,949.84
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $147.91 / $204.17
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $933.25