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Connecticut 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
$105.07 / $153.91 / $2,313.65
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.03 / $103.05 / $127.29
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89.58 / $101.03 / $116.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.03 / $101.03 / $101.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$101.03 / $101.03 / $101.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.03 / $101.03 / $101.03
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.03 / $101.03 / $185.67
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.98 / $101.03 / $106.08