go back

Kentucky 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 / $70.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.70 / $70.70 / $71.40
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.70 / $70.70 / $73.52
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.70 / $98.98 / $113.12
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.70 / $77.77 / $102.52
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.70 / $255.00 / $255.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.70 / $70.70 / $178.18
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.04 / $73.54 / $95.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.70 / $70.70 / $75.72