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PuraPly XT

New York 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$2570%50%90th$71Professionalmedian $71 · 10th–90th $71$1700%50%90th$71$100.0$500.0$2.0K$10.0K$50.0K

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
$74.13
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$158.49
Cigna
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$165.96
Typical High
$257.04
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$257.04
Typical High
$501.19
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$251.19
Typical High
$257.04
Excellus BCBS
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$74.13
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$74.13
Typical High
$74.13
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$91.20
Median
$50,118.72
Typical High
$75,857.76
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$77.62
Typical High
$120.23
United
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$138.04
Typical High
$208.93
United
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$120.23
Typical High
$251.19
Univera
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$77.62
Univera
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$74.13
Typical High
$74.13