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PuraPly AM

New Hampshire 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?

$100

Typical negotiated rate. In New Hampshire, July 2026.

Insurers have agreed to pay about $100 for this service. The price depends on where it is billed: about $100 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$100$100 to $126
FacilityA hospital or hospital-owned outpatient department$120$100 to $240

How much rates vary

Facilitymedian $120 · 10th to 90th $87 to $891Professionalmedian $100 · 10th to 90th $100 to $141
$100$200$500$1Kfacility $120professional $100

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
$100.00
Median
$120.23
Typical High
$891.25
Aetna
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$120.23
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$165.96
Cigna
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$251.19
Typical High
$338.84
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$165.96
United
Setting
Facility
Modifier
Global
Typical Low
$208.93
Median
$208.93
Typical High
$208.93
United
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$125.89
Typical High
$125.89
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$83.18
Typical High
$144.54

Where New Hampshire 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.

New Hampshire· 48th of 51

$100

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.