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Georgia 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
$70.70 / $70.70 / $70.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.70 / $70.70 / $74.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.70 / $70.70 / $72.11
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.70 / $70.70 / $138.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.69 / $66.69 / $70.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.70 / $70.70 / $90.04
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.64 / $72.64 / $589.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.18 / $130.79 / $239.19
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$73.54 / $143.40 / $143.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.70 / $70.70 / $116.66