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Washington, DC rates for HCPCS Q4249

AMNIPLY, for topical use only, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,969.89 / $1,969.89 / $1,969.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,969.89 / $1,969.89 / $1,969.89
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$306.00 / $306.00 / $306.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,858.38 / $1,858.38 / $1,969.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,969.89 / $1,969.89 / $2,508.82
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,674.41 / $1,674.41 / $2,431.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,969.89 / $1,969.89 / $3,192.76