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Washington, DC rates for HCPCS Q4253

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

Facilitymedian $76 · 10th–90th $76–$2630%50%90th$76Professionalmedian $76 · 10th–90th $76–$890%50%90th$76$50.0$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $75.86
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $79.43
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $114.82 / $269.15
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $263.03 / $446.68
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $977.24 / $1,023.29
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $208.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $125.89 / $213.80