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Arkansas rates for HCPCS Q4197

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.18 / $83.18 / $83.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.79 / $70.79 / $83.18
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.86 / $75.86 / $75.86
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $75.86 / $75.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.07 / $70.79 / $70.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.79 / $70.79 / $79.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $190.55 / $251.19