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Maine rates for HCPCS Q4196

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

Facilitymedian $145 · 10th–90th $87–$3630%20%40%10th90th$145Professionalmedian $100 · 10th–90th $100–$1260%50%90th$100$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $107.15
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $87.10 / $109.65
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $125.89 / $181.97
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $144.54 / $363.08
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $123.03
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $102.33 / $213.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $107.15 / $125.89