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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 July 2026.

Facilitymedian $71 · 10th–90th $71$2140%50%90th$71Professionalmedian $71 · 10th–90th $71$5500%50%90th$71$0.1$0.5$2.0$10.0$50.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. 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
$549.54
Cigna
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$245.47
Typical High
$302.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$93.33
Typical High
$125.89
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$186.21
Typical High
$389.05
Medica
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$95.50
Typical High
$316.23
Medica
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$213.80
Midlands
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$89.13
Typical High
$218.78
Midlands
Setting
Facility
Modifier
Global
Typical Low
$204.17
Median
$239.88
Typical High
$302.00
Midlands
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$218.78
Typical High
$218.78
United
Setting
Facility
Modifier
Global
Typical Low
$0.13
Median
$114.82
Typical High
$208.93
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$141.25
Wellmark
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$70.79
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$70.79
Typical High
$70.79