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Wyoming rates for HCPCS Q4248

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

Facilitymedian $479 · 10th–90th $129–$6,0260%10%20%10th90th$479Professionalmedian $562 · 10th–90th $135–$2,6920%20%10th90th$562$100.0$200.0$500.0$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $128.82 / $128.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $549.54 / $1,000.00
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,290.87 / $2,691.53 / $2,691.53
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $239.88 / $478.63
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $181.97 / $181.97
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,570.88 / $4,570.88 / $6,025.60
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $2,818.38