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Wyoming 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
$107.92 / $107.92 / $107.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.94 / $106.75 / $107.73
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.44 / $206.40 / $206.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$92.40 / $92.40 / $92.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.94 / $138.59 / $138.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.94 / $97.94 / $97.94