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New York rates for HCPCS 97605

Negative pressure wound therapy (eg, vacuum assisted drainage collection), utilizing durable medical equipment (DME), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session; total wound(s) surface area less than or equal to 50 square centimeters

Facilitymedian $83 · 10th–90th $26–$4790%10%10th90th$83Professionalmedian $42 · 10th–90th $23–$1070%10%20%10th90th$42$5.0$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$26.30 / $83.18 / $478.63
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.44 / $40.74 / $109.65
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $33.88 / $33.88
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $44.67 / $102.33
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$35.48 / $35.48 / $35.48
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $35.48 / $60.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $53,703.18
Cigna
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$3.98 / $3.98 / $3.98
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $41.69 / $97.72
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.12 / $31.62 / $77.62
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $58.88 / $93.33
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $53.70 / $79.43
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $354.81 / $407.38
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50,118.72 / $53,703.18 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $57.54 / $61.66
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $426.58 / $575.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.89 / $38.90 / $85.11
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.95 / $26.92 / $109.65
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $54.95 / $87.10