go back

Illinois rates for HCPCS Q4197

PuraPly XT Antimicrobial 5x5CM EX SHEE 0.1 %

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.70 / $70.70 / $315.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.70 / $70.70 / $77.77
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.25 / $83.25 / $93.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.70 / $70.70 / $70.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.70 / $70.70 / $93.37
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.74 / $98.98 / $402.85
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.91 / $91.91 / $91.91
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $40.00 / $110.31
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$121.34 / $121.34 / $121.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.70 / $70.70 / $79.89