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Arkansas rates for HCPCS Q4250

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,548.13 / $3,548.13 / $3,548.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,951.21 / $2,951.21 / $3,548.13
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,235.94 / $3,235.94 / $3,235.94
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,235.94 / $3,235.94 / $3,235.94
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,818.38 / $2,951.21 / $2,951.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,951.21 / $2,951.21 / $3,090.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $2,398.83 / $2,818.38