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Massachusetts rates for HCPCS Q4250

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

Facilitymedian $2,951 · 10th–90th $151–$7,0790%50%10th90th$2,951Professionalmedian $2,951 · 10th–90th $174–$3,1620%50%10th90th$2,951$50.0$200.0$1.0K$5.0K$20.0K

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
$2,951.21 / $2,951.21 / $2,951.21
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,951.21 / $2,951.21 / $3,311.31
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,128.31 / $8,128.31 / $8,128.31
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $7,413.10
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $269.15 / $549.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $177.83 / $6,918.31
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,951.21 / $2,951.21 / $2,951.21
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,128.31 / $8,128.31 / $8,128.31
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $7,413.10
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $4,677.35 / $6,165.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $2,398.83 / $2,951.21