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Kansas 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
$98.97 / $98.97 / $98.97
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.70 / $72.11 / $98.97
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 / $70.70
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.45 / $108.40 / $300.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.04 / $71.04 / $453.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.70 / $70.70 / $102.52