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PuraPly AM

Montana rates for HCPCS Q4196

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

Rates data updated July 2026.

How much does PuraPly AM cost?

$112

Typical negotiated rate. In Montana, July 2026.

Insurers have agreed to pay about $112 for this service. The price depends on where it is billed: about $112 from a physician practice, and about $120 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 6 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$112$102 to $126
FacilityA hospital or hospital-owned outpatient department$120$110 to $155

How much rates vary

Facilitymedian $120 · 10th to 90th $71 to $316Professionalmedian $112 · 10th to 90th $100 to $224
$100$1K$10K$100Kfacility $120professional $112

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
Facility
Modifier
Global
Typical Low
$457.09
Median
$457.09
Typical High
$457.09
Aetna
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$112.20
Typical High
$223.87
BCBS
Setting
Facility
Modifier
Global
Typical Low
$64,565.42
Median
$75,857.76
Typical High
$91,201.08
Cigna
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$120.23
Typical High
$144.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$125.89
Typical High
$125.89
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$109.65
Typical High
$204.17
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$109.65
Typical High
$204.17
Providence
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$120.23
Typical High
$204.17
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$120.23
Typical High
$204.17
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 Vermont. 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

$112

AK $186VT $100

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.