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Nevada 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
$70.70 / $71.04 / $77.06
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.70 / $70.70 / $77.77
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.70 / $71.04 / $71.04
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 / $70.70
Hometown Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.70 / $76.70 / $300.00
Hometown Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.38 / $127.38 / $127.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.70 / $70.70 / $70.70