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PuraPly AM

South Dakota 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?

$126

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $126 for this service. The price depends on where it is billed: about $126 from a physician practice, and about $107 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 8 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$126$100 to $174
FacilityA hospital or hospital-owned outpatient department$107$100 to $178

How much rates vary

Facilitymedian $107 · 10th to 90th $100 to $457Professionalmedian $126 · 10th to 90th $100 to $617
$100$200$500facility $107professional $126

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
$457.09
Typical High
$457.09
Aetna
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$616.60
Avera
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$107.15
Typical High
$112.20
Cigna
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$144.54
Typical High
$177.83
Cigna
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$125.89
Typical High
$134.90
Medica
Setting
Facility
Modifier
Global
Typical Low
$97.72
Median
$165.96
Typical High
$204.17
Medica
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$97.72
Typical High
$467.74
Midlands
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$117.49
Typical High
$125.89
Midlands
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$169.82
Typical High
$204.17
Midlands
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$131.83
Typical High
$131.83
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$173.78
Typical High
$173.78
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$239.88
Wellmark
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00

Where South Dakota 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.

South Dakota· 3rd of 51

$126

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.