go back

Alaska rates for HCPCS Q4253

Zenith Amniotic Membrane, per sq cm (add-on, list separately in addition to primary procedure)

Facilitymedian $141 · 10th–90th $76–$1,2590%10%20%10th90th$141Professionalmedian $79 · 10th–90th $76–$5130%20%40%10th90th$79$100.0$200.0$500.0$1.0K$2.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $131.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $144.54 / $144.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $112.20 / $363.08
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $309.03 / $616.60
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $1,584.89 / $2,511.89
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,258.93 / $1,380.38
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $120.23 / $363.08
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $147.91
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $125.89 / $354.81