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PuraPly

Illinois rates for HCPCS Q4195

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

Rates data updated July 2026.

Facilitymedian $204 · 10th–90th $98$2820%10%20%10th90th$204Professionalmedian $100 · 10th–90th $98$1290%20%10th90th$100$100.0$200.0$500.0$1.0K

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
$97.72
Typical High
$218.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$97.72
Typical High
$107.15
BCBS
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$213.80
Typical High
$295.12
BCBS
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$128.82
Typical High
$128.82
Cigna
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$194.98
Typical High
$302.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$131.83
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$158.49
Typical High
$281.84
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Molina
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$114.82
Typical High
$114.82
United
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$208.93
United
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$125.89
Typical High
$138.04