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Georgia 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
$2,979.56 / $2,979.56 / $2,979.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,979.56 / $2,979.56 / $3,128.53
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,979.56 / $2,979.56 / $3,039.15
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,979.56 / $2,979.56 / $5,839.94
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,810.90 / $2,810.90 / $2,979.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,979.55 / $2,979.55 / $3,794.72
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,422.50 / $2,422.50 / $2,868.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$192.97 / $239.19 / $5,512.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,979.56 / $2,979.56 / $3,309.67