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Mississippi 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
$3,128.53 / $3,128.53 / $3,575.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,979.56 / $3,128.53 / $3,575.47
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,979.55 / $2,979.55 / $2,979.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,979.55 / $2,979.55 / $2,979.55
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,816.79 / $2,979.56 / $3,873.43