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PuraPly

Virginia rates for HCPCS Q4195

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

Rates data updated July 2026.

Facilitymedian $129 · 10th–90th $98$2880%20%10th90th$129Professionalmedian $123 · 10th–90th $98$2140%20%10th90th$123$2.0$10.0$50.0$200.0$1.0K$5.0K

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
$102.33
Typical High
$102.33
Aetna
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$97.72
Typical High
$123.03
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$177.83
Typical High
$302.00
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$165.96
Typical High
$295.12
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$104.71
Typical High
$169.82
Cigna
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$251.19
Typical High
$316.23
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$169.82
Typical High
$239.88
Medcost
Setting
Facility
Modifier
Global
Typical Low
$97.72
Median
$107.15
Typical High
$204.17
Medcost
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$97.72
Typical High
$194.98
Sentara
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$138.04
Typical High
$524.81
Sentara
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$138.04
Typical High
$524.81
United
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$190.55
Typical High
$338.84
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$134.90