go back

Minnesota rates for HCPCS Q4253

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

Facilitymedian $178 · 10th–90th $71–$4680%20%10th90th$178Professionalmedian $102 · 10th–90th $65–$1260%20%10th90th$102$0.2$1.0$5.0$20.0$100.0$500.0$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
$75.86 / $75.86 / $75.86
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $165.96
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $177.83 / $177.83
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $107.15 / $125.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $426.58 / $602.56
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $85.11 / $93.33
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $213.80 / $467.74
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $72.44 / $83.18
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $83.18 / $181.97
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $83.18 / $112.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $125.89 / $263.03