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PuraPly XT

Alaska rates for HCPCS Q4197

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

Rates data updated July 2026.

How much does PuraPly XT cost?

$158

Typical negotiated rate. In Alaska, July 2026.

Insurers have agreed to pay about $158 for this service. The price depends on where it is billed: about $158 from a physician practice, and about $132 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$158$70.79 to $309
FacilityA hospital or hospital-owned outpatient department$132$74.13 to $178

How much rates vary

Facilitymedian $132 · 10th to 90th $71 to $363Professionalmedian $158 · 10th to 90th $71 to $417
$100$200$500$1K$2Kfacility $132professional $158

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
$158.49
Median
$158.49
Typical High
$158.49
Aetna
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$131.83
Cigna
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$112.20
Typical High
$331.13
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$302.00
Typical High
$512.86
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$416.87
Typical High
$660.69
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$331.13
Typical High
$363.08
Providence
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$112.20
Typical High
$331.13
Providence
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$125.89
Typical High
$125.89
United
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$190.55
Typical High
$380.19

Where Alaska sits

The same service costs 2.2 times more in Alaska than in Tennessee. 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.

Alaska· 1st of 51

$158

AK $158TN $70.79

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.