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Kentucky rates for HCPCS Q4196

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

Facilitymedian $120 · 10th–90th $112–$1200%50%10th$120Professionalmedian $100 · 10th–90th $100–$1260%50%90th$100$20.0$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $112.20
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $120.23 / $120.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $109.65
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $162.18
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $107.15 / $141.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $173.78 / $173.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $426.58
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $109.65 / $144.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $251.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $125.89 / $128.82