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Minnesota rates for HCPCS Q4195

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.94 / $97.94 / $97.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.94 / $97.94 / $105.78
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $107.92 / $215.87
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.34 / $107.92 / $175.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$118.34 / $217.46 / $305.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.08 / $108.20 / $129.63
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$105.10 / $199.29 / $275.45
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.85 / $102.08 / $102.08
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$107.92 / $107.92 / $238.09
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.92 / $107.92 / $247.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.94 / $97.94 / $193.21