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PuraPly

Montana rates for HCPCS Q4195

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

Rates data updated July 2026.

How much does PuraPly cost?

$107

Typical negotiated rate. In Montana, July 2026.

Insurers have agreed to pay about $107 for this service. The price depends on where it is billed: about $107 from a physician practice, and about $115 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 5 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$107$97.72 to $115
FacilityA hospital or hospital-owned outpatient department$115$89.13 to $145

How much rates vary

Facilitymedian $115 · 10th to 90th $76 to $204Professionalmedian $107 · 10th to 90th $98 to $126
$100$200facility $115professional $107

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$107.15
Typical High
$114.82
Cigna
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$114.82
Typical High
$144.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$125.89
Typical High
$125.89
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$75.86
Typical High
$186.21
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$75.86
Typical High
$186.21
Providence
Setting
Facility
Modifier
Global
Typical Low
$97.72
Median
$114.82
Typical High
$204.17
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$114.82
Typical High
$173.78
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89

Where Montana sits

The same service costs 1.9 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.

Montana· 11th of 51

$107

AK $182NC $97.72

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.