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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
$84.84 / $84.84 / $84.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.70 / $74.23 / $84.84
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.06 / $77.06 / $77.06
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.31 / $77.06 / $77.06
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.69 / $70.70 / $70.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.70 / $70.70 / $76.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.04 / $70.70 / $81.31