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PuraPly

Michigan rates for HCPCS Q4195

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

Rates data updated October 2026.

How much does PuraPly cost?

$107

Typical negotiated rate. In Michigan, October 2026.

Insurers have agreed to pay about $107 for this service. The price depends on where it is billed: about $102 from a physician practice, and about $135 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$102$100 to $126
FacilityA hospital or hospital-owned outpatient department$135$120 to $204

How much rates vary

Facilitymedian $135 · 10th to 90th $102 to $282Professionalmedian $102 · 10th to 90th $98 to $129
$100$200facility $135professional $102

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$100.00
Median
$102.33
Typical High
$102.33
Aetna
Setting
Professional
Modifier
None
Typical Low
$100.00
Median
$100.00
Typical High
$102.33
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$50.12
Median
$50.12
Typical High
$51.29
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$19.95
Median
$19.95
Typical High
$20.42
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$15.14
Median
$15.14
Typical High
$15.14
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$10.00
Median
$10.00
Typical High
$10.23
BCBS Michigan
Setting
Facility
Modifier
None
Typical Low
$120.23
Median
$120.23
Typical High
$120.23
BCBS Michigan
Setting
Professional
Modifier
None
Typical Low
$112.20
Median
$120.23
Typical High
$120.23
Cigna
Setting
Professional
Modifier
None
Typical Low
$93.33
Median
$93.33
Typical High
$125.89
Health Alliance Plan
Setting
Facility
Modifier
None
Typical Low
$134.90
Median
$141.25
Typical High
$288.40
Health Alliance Plan
Setting
Professional
Modifier
None
Typical Low
$97.72
Median
$100.00
Typical High
$131.83
Health Alliance Plan
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$50.12
Median
$50.12
Typical High
$50.12
Health Alliance Plan
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$19.95
Median
$19.95
Typical High
$19.95
Health Alliance Plan
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$15.14
Median
$15.14
Typical High
$15.14
Health Alliance Plan
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$10.00
Median
$10.00
Typical High
$10.00
Priority Health
Setting
Professional
Modifier
None
Typical Low
$93.33
Median
$93.33
Typical High
$125.89
United
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$134.90

Where Michigan sits

The same service costs 2.0 times more in Alaska than in North Carolina. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Michigan· 43rd of 51

$107

AK $182NC $89.13

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.