go back

Tennessee 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 / $977.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $549.54 / $660.69
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $549.54 / $630.96
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$549.54 / $549.54 / $549.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $549.54 / $549.54
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,128.31 / $8,128.31 / $8,128.31
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10,471.29 / $10,715.19 / $10,715.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $2,187.76 / $2,691.53