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New Jersey rates for HCPCS Q4197

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

Facilitymedian $2,089 · 10th–90th $74–$23,9880%10%10th90th$2,089Professionalmedian $71 · 10th–90th $71–$1260%50%90th$71$50.0$200.0$1.0K$5.0K$20.0K

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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $70.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $85.11
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $107.15 / $177.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $229.09 / $257.04
Horizon BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $11,481.54 / $25,118.86
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $74.13 / $74.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$29.51 / $173.78 / $173.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $125.89 / $141.25