go back

Idaho rates for HCPCS Q4197

PuraPly XT Antimicrobial 5x5CM EX SHEE 0.1 %

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71.04 / $71.04 / $71.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.70 / $77.77 / $88.37
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 / $70.70
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71.04 / $88.37 / $113.11
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.70 / $72.11 / $88.38
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $78.00 / $143.40
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.84 / $84.84 / $84.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.70 / $70.70 / $70.70