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PuraPly

California rates for HCPCS Q4195

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

Rates data updated July 2026.

Facilitymedian $126 · 10th–90th $98$5750%20%40%10th90th$126Professionalmedian $102 · 10th–90th $98$2290%20%40%10th90th$102$0.1$2.0$50.0$1.0K$20.0K$500.0K

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
$97.72
Median
$100.00
Typical High
$100.00
Aetna
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$97.72
Typical High
$114.82
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$97.72
Median
$123.03
Typical High
$309.03
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$107.15
Typical High
$245.47
Blue Shield
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$1,000.00
Typical High
$1,949.84
Blue Shield
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$288.40
Cigna
Setting
Facility
Modifier
Global
Typical Low
$131.83
Median
$218.78
Typical High
$295.12
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$144.54
Contra Costa Health
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$85.11
Typical High
$131.83
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$169.82
Typical High
$269.15
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$707.95
Typical High
$707.95
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$660.69
Typical High
$660.69
Providence
Setting
Facility
Modifier
Global
Typical Low
$97.72
Median
$151.36
Typical High
$234.42
Providence
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$144.54
Sutter Health Plus
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$239.88
Typical High
$239.88
The Alliance
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$107.15
Typical High
$165.96
United
Setting
Facility
Modifier
Global
Typical Low
$389.05
Median
$389.05
Typical High
$389.05
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$213.80