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Tennessee 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
$98.54 / $101.03 / $172.45
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.03 / $101.03 / $111.13
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.54 / $105.46 / $205.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$101.03 / $101.03 / $101.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.03 / $101.03 / $101.03
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$174.32 / $547.60 / $547.60
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$466.64 / $466.64 / $466.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.03 / $101.03 / $101.03