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New Hampshire rates for HCPCS Q4250

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

Facilitymedian $2,951 · 10th–90th $132–$3,5480%20%10th90th$2,951Professionalmedian $2,951 · 10th–90th $2,399–$3,7150%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
$131.83 / $2,951.21 / $3,548.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,951.21 / $2,951.21 / $3,715.35
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $2,951.21 / $2,951.21
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $251.19 / $338.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,951.21 / $2,951.21 / $4,786.30
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $1,412.54 / $2,951.21
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $144.54 / $162.18