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Minnesota rates for HCPCS Q4253

Zenith Amniotic Membrane Per Square Centimeter

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.79 / $75.79 / $75.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.79 / $75.79 / $78.81
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $1.00 / $179.15
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.54 / $83.18 / $470.75
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$221.70 / $407.41 / $572.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.59 / $91.08 / $110.75
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$196.90 / $373.36 / $516.04
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.86 / $72.86 / $99.09
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.18 / $83.18 / $183.20
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.18 / $83.18 / $190.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.79 / $75.79 / $149.51