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Iowa rates for HCPCS Q4197

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.70 / $70.70 / $71.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.93 / $93.66 / $214.18
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.70 / $127.97 / $321.30
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71.04 / $120.06 / $313.80
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.04 / $71.04 / $214.18
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$82.81 / $88.24 / $169.13
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.24 / $94.44 / $214.18
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$599.90 / $599.90 / $599.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.70 / $70.70 / $77.77
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71.04 / $71.04 / $71.04
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.12 / $71.04 / $71.04