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PuraPly XT

Minnesota 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?

$107

Typical negotiated rate. In Minnesota, July 2026.

Insurers have agreed to pay about $107 for this service. The price depends on where it is billed: about $105 from a physician practice, and about $186 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$105$72.44 to $126
FacilityA hospital or hospital-owned outpatient department$186$97.72 to $234

How much rates vary

Facilitymedian $186 · 10th to 90th $71 to $257Professionalmedian $105 · 10th to 90th $63 to $126
$100$200facility $186professional $105

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
$70.79
Median
$70.79
Typical High
$70.79
Aetna
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$177.83
BCBS
Setting
Facility
Modifier
Global
Typical Low
$74.13
Median
$109.65
Typical High
$257.04
BCBS
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$107.15
Typical High
$125.89
Cigna
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$199.53
Typical High
$275.42
Cigna
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$87.10
Typical High
$95.50
Health Partners
Setting
Facility
Modifier
Global
Typical Low
$134.90
Median
$190.55
Typical High
$281.84
Health Partners
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$74.13
Typical High
$102.33
Medica
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$158.49
Medica
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$95.50
United
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$125.89
Typical High
$257.04

Where Minnesota 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.

Minnesota· 6th of 51

$107

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.