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Minnesota 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
$101.03 / $101.03 / $101.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.03 / $101.03 / $111.13
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $98.54 / $240.78
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.83 / $98.54 / $103.77
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$161.12 / $296.08 / $416.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.51 / $124.78 / $136.44
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$143.10 / $271.35 / $375.04
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.44 / $107.44 / $114.48
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$98.54 / $98.54 / $217.41
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.54 / $98.54 / $226.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.03 / $101.03 / $183.15