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Nebraska 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 / $107.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.94 / $97.94 / $107.73
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$94.25 / $110.88 / $110.88
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$105.34 / $110.88 / $122.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.94 / $154.65 / $221.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.30 / $120.21 / $154.27
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$107.92 / $161.88 / $205.05
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.17 / $107.92 / $211.87
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$96.16 / $120.21 / $267.25
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.16 / $120.21 / $208.64
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$187.70 / $187.70 / $187.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.04 / $97.94 / $107.73