go back

Oklahoma 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
$109.11 / $152.35 / $3,354.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.04 / $109.11 / $109.11
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95.31 / $95.31 / $101.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.03 / $101.03 / $101.03
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$104.83 / $111.74 / $205.08
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.54 / $98.54 / $145.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.03 / $101.03 / $111.41