go back

Rhode Island 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
$101.86 / $101.86 / $101.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.94 / $97.94 / $101.86
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.02 / $194.67
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$92.40 / $97.94 / $97.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.94 / $97.94 / $97.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.94 / $97.94 / $97.94