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Nebraska rates for HCPCS Q4253

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

Facilitymedian $120 · 10th–90th $76–$2290%20%10th90th$120Professionalmedian $76 · 10th–90th $76–$1150%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
$75.86 / $75.86 / $128.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $91.20
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $81.28 / $85.11
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $81.28 / $85.11
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $208.93 / $229.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $100.00 / $177.83
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $128.82 / $467.74
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $83.18 / $1,148.15
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $100.00 / $177.83
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $208.93 / $309.03
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $177.83 / $208.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $102.33 / $190.55
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $125.89 / $141.25