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PuraPly XT

Iowa rates for HCPCS Q4197

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

Rates data updated October 2026.

How much does PuraPly XT cost?

$85.11

Typical negotiated rate. In Iowa, October 2026.

Insurers have agreed to pay about $85.11 for this service. The price depends on where it is billed: about $89.13 from a physician practice, and about $70.79 from a hospital or other facility.

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 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$89.13$70.79 to $158
FacilityA hospital or hospital-owned outpatient department$70.79$70.79 to $70.79

How much rates vary

Facilitymedian $71 · 10th to 90th $71 to $245Professionalmedian $89 · 10th to 90th $66 to $214
$100$200$500facility $71professional $89

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$66.07
Median
$66.07
Typical High
$66.07
Aetna
Setting
Professional
Modifier
None
Typical Low
$66.07
Median
$66.07
Typical High
$70.79
Cigna
Setting
Facility
Modifier
None
Typical Low
$190.55
Median
$239.88
Typical High
$269.15
Cigna
Setting
Professional
Modifier
None
Typical Low
$75.86
Median
$190.55
Typical High
$218.78
Hally Health
Setting
Professional
Modifier
None
Typical Low
$70.79
Median
$109.65
Typical High
$338.84
Medica
Setting
Facility
Modifier
None
Typical Low
$85.11
Median
$213.80
Typical High
$302.00
Medica
Setting
Professional
Modifier
None
Typical Low
$70.79
Median
$74.13
Typical High
$457.09
Midlands
Setting
Professional
Modifier
None
Typical Low
$151.36
Median
$190.55
Typical High
$218.78
Midlands
Setting
Facility
Modifier
None
Typical Low
$190.55
Median
$239.88
Typical High
$302.00
Midlands
Setting
Professional
Modifier
None
Typical Low
$109.65
Median
$109.65
Typical High
$218.78
United
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$134.90
Wellmark
Setting
Facility
Modifier
None
Typical Low
$70.79
Median
$70.79
Typical High
$70.79
Wellmark
Setting
Professional
Modifier
None
Typical Low
$70.79
Median
$70.79
Typical High
$70.79
4 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$33.11
Median
$33.11
Typical High
$35.48
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$13.18
Median
$13.18
Typical High
$14.13
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$9.77
Median
$9.77
Typical High
$10.72
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$6.61
Median
$6.61
Typical High
$7.08

Where Iowa sits

The same service costs 3.6 times more in Wyoming than in Indiana. 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.

Iowa· 44th of 51

$85.11

WY $257IN $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.