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Michigan rates for HCPCS Q4250

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

Facilitymedian $3,090 · 10th–90th $102–$4,6770%50%10th90th$3,090Professionalmedian $2,951 · 10th–90th $2,399–$3,3110%50%10th90th$2,951$50.0$200.0$1.0K$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
Facility
Modifier
Typical Low / Median / Typical High
$3,090.30 / $3,090.30 / $3,090.30
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,951.21 / $2,951.21 / $3,311.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $181.97
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,019.95 / $3,235.94 / $8,709.64
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $3,019.95 / $3,890.45
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $4,677.35
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $2,884.03