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Oregon rates for HCPCS Q4196

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

Facilitymedian $100 · 10th–90th $98–$1660%50%10th90th$100Professionalmedian $117 · 10th–90th $100–$2750%50%10th90th$117$100.0$500.0$2.0K$10.0K$50.0K$200.0K$1.0M

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 / $117.49 / $549.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $102.33 / $151.36
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $147.91 / $269.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $138.04
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $263.03 / $323.59
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $128.82 / $223.87
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $239.88 / $316.23
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $100.00 / $112.20
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $125.89 / $263.03
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $125.89 / $223.87
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $158.49 / $302.00
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $125.89 / $125.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89