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Missouri rates for HCPCS Q4195

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

Facilitymedian $135 · 10th–90th $100$2690%10%20%10th90th$135Professionalmedian $98 · 10th–90th $98$1260%20%40%90th$98$50.0$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 / $218.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $97.72 / $117.49
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $109.65 / $131.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $223.87 / $302.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $144.54
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $151.36 / $323.59
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $107.15 / $776.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $134.90 / $144.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $125.89 / $128.82