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Missouri rates for HCPCS Q4196

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

Facilitymedian $141 · 10th–90th $100–$3240%20%10th90th$141Professionalmedian $102 · 10th–90th $98–$1320%50%10th90th$102$50.0$100.0$200.0$500.0$1.0K

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 / $213.80 / $1,778.28
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $120.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $109.65 / $131.83
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $144.54 / $186.21
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $223.87 / $302.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $144.54
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $144.54 / $295.12
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $97.72 / $467.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $141.25 / $154.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $125.89 / $128.82