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Arkansas rates for HCPCS Q4253

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

Facilitymedian $83 · 10th–90th $83–$890%50%90th$83Professionalmedian $76 · 10th–90th $76–$1000%50%90th$76$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
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $89.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $89.13
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $83.18 / $83.18
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $83.18 / $83.18
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $173.78 / $263.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $138.04
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $125.89 / $144.54