go back

Kansas 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
$645.65 / $645.65 / $645.65
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $562.34 / $691.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$169.82 / $524.81 / $549.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $549.54 / $549.54
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,047.13 / $3,019.95 / $4,365.16
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,818.38 / $2,818.38 / $9,332.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,290.87 / $2,691.53 / $2,818.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $2,691.53 / $2,818.38