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Colorado rates for HCPCS Q4196

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $100.00 / $117.49
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$109.65 / $109.65 / $109.65
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $109.65 / $109.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95.50 / $95.50 / $134.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $100.00 / $104.71
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $190.55 / $213.80
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.03 / $134.90 / $134.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $125.89 / $165.96