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Vermont rates for HCPCS Q4195

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.72 / $97.72 / $107.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.33 / $93.33 / $109.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.72 / $97.72 / $102.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $131.83 / $181.97