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Vermont rates for HCPCS Q4197

PuraPly XT Antimicrobial 5x5CM EX SHEE 0.1 %

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.70 / $70.70 / $70.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.69 / $83.25 / $138.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.70 / $70.70 / $138.75
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.69 / $83.25 / $138.75
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.70 / $70.70 / $138.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.70 / $70.70 / $212.10