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Wisconsin rates for HCPCS Q4249

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

Facilitymedian $2,042 · 10th–90th $933$4,4670%20%10th90th$2,042Professionalmedian $1,950 · 10th–90th $148$2,1880%20%10th90th$1,950$5.0$20.0$100.0$500.0$2.0K$10.0K

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,041.74 / $2,041.74
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $1,949.84 / $2,187.76
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $263.03 / $691.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $199.53 / $389.05
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $147.91 / $181.97
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,949.84 / $2,041.74 / $4,466.84
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $1,862.09 / $4,073.80
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $1,778.28 / $9,549.93
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $64.57 / $1,949.84
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $933.25 / $933.25
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $275.42 / $446.68
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,949.84 / $2,290.87 / $8,128.31
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $2,238.72 / $10,232.93
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,630.27 / $2,630.27 / $3,235.94
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $2,691.53 / $6,309.57
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $2,238.72