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Virginia rates for HCPCS Q4197

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

Facilitymedian $178 · 10th–90th $71–$3470%20%10th90th$178Professionalmedian $74 · 10th–90th $71–$3020%50%10th90th$74$2.0$10.0$50.0$200.0$1.0K$5.0K

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 / $74.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $302.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $239.88 / $426.58
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $257.04 / $257.04
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $251.19 / $316.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $173.78 / $275.42
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $79.43 / $302.00
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $281.84
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $204.17 / $891.25
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $204.17 / $891.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $275.42
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $125.89 / $134.90