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Wyoming 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 / $98.54 / $98.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.03 / $110.12 / $111.13
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$174.32 / $205.08 / $205.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95.31 / $95.31 / $95.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.03 / $142.97 / $142.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.03 / $101.03 / $101.03