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Iowa rates for HCPCS Q4197

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

Facilitymedian $71 · 10th–90th $71–$850%50%90th$71Professionalmedian $71 · 10th–90th $71–$1780%50%90th$71$0.1$0.5$2.0$10.0$50.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $70.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $128.82
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $245.47 / $302.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $93.33 / $125.89
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $186.21 / $389.05
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $95.50 / $316.23
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $213.80
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $89.13 / $213.80
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $245.47 / $302.00
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $213.80 / $213.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.07 / $74.13 / $120.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $125.89 / $138.04
Wellmark
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $70.79
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $70.79