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Indiana rates for HCPCS Q4195

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

Facilitymedian $200 · 10th–90th $100$5130%10%10th90th$200Professionalmedian $98 · 10th–90th $98$1260%50%90th$98$100.0$200.0$500.0

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
$97.72 / $100.00 / $100.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $97.72 / $102.33
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $213.80 / $512.86
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $97.72 / $158.49
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $117.49 / $177.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $346.74 / $346.74
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $128.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $125.89 / $134.90