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PuraPly XT

Washington, DC rates for HCPCS Q4197

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

Rates data updated July 2026.

Facilitymedian $71 · 10th–90th $71$2630%50%90th$71Professionalmedian $71 · 10th–90th $71$1260%50%90th$71$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$70.79
Aetna
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$74.13
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$229.09
Typical High
$257.04
Cigna
Setting
Facility
Modifier
Global
Typical Low
$194.98
Median
$263.03
Typical High
$446.68
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$257.04
Typical High
$275.42
United
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$125.89
Typical High
$190.55