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PuraPly XT

New Mexico rates for HCPCS Q4197

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

Rates data updated July 2026.

Facilitymedian $123 · 10th–90th $71$2820%20%10th90th$123Professionalmedian $71 · 10th–90th $71$1260%50%90th$71$50.0$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. 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
$89.13
BCBS
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$83.18
Typical High
$177.83
Cigna
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$257.04
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Molina
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$60.26
Typical High
$109.65
Providence
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$112.20
Typical High
$281.84
Providence
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$125.89
Typical High
$125.89
United
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$208.93
Typical High
$208.93
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89