go back

Texas rates for HCPCS Q4196

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

Facilitymedian $135 · 10th–90th $63$4270%10%20%10th90th$135Professionalmedian $102 · 10th–90th $100$1260%50%10th90th$102$2.0$10.0$50.0$200.0$1.0K$5.0K

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 / $100.00 / $7,585.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $102.33 / $112.20
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $134.90 / $371.54
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $63.10
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $120.23 / $125.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $316.23 / $851.14
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $707.95
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $660.69
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $104.71 / $229.09
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $109.65 / $223.87
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $97.72 / $104.71
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $251.19 / $251.19
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $107.15 / $234.42
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $104.71 / $173.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $125.89 / $125.89
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $125.89 / $125.89