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Alaska rates for HCPCS Q4250

AmnioAmp-MP, per sq cm (add-on, list separately in addition to primary procedure)

Facilitymedian $3,162 · 10th–90th $178–$6,1660%20%10th90th$3,162Professionalmedian $2,951 · 10th–90th $219–$3,3880%50%10th90th$2,951$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,951.21 / $2,951.21 / $3,467.37
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $144.54 / $144.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $3,090.30 / $5,623.41
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $338.84 / $954.99
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,981.07 / $3,981.07 / $6,309.57
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,818.38 / $3,162.28 / $3,388.44
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $3,090.30 / $5,623.41
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $3,548.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $125.89 / $446.68