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Michigan rates for HCPCS Q4197

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

Facilitymedian $72 · 10th–90th $72$3390%50%90th$72Professionalmedian $71 · 10th–90th $71$1380%50%90th$71$100.0$200.0$500.0$1.0K

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
Setting
Facility
Modifier
Global
Typical Low
$72.44
Median
$72.44
Typical High
$72.44
Aetna
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$89.13
Cigna
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$125.89
Typical High
$125.89
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$338.84
Typical High
$933.25
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$131.83
Typical High
$398.11
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
United
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$302.00
United
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$125.89
Typical High
$128.82