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Washington, DC rates for HCPCS Q4248

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$549.54 / $549.54 / $549.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $549.54 / $575.44
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,000.00 / $7,413.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$524.81 / $549.54 / $549.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $549.54 / $707.95
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.04 / $2,290.87 / $2,398.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,818.38 / $2,818.38 / $2,818.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $1,737.80 / $2,818.38