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PuraPly XT

Virginia 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?

$126

Typical negotiated rate. In Virginia, July 2026.

Insurers have agreed to pay about $126 for this service. The price depends on where it is billed: about $126 from a physician practice, and about $178 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 8 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$126$70.79 to $240
FacilityA hospital or hospital-owned outpatient department$178$87.10 to $234

How much rates vary

Facilitymedian $178 · 10th to 90th $71 to $347Professionalmedian $126 · 10th to 90th $71 to $302
$100$200$500$1K$2K$5K$10Kfacility $178professional $126

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
$74.13
Typical High
$74.13
Aetna
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$177.83
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$239.88
Typical High
$426.58
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$257.04
Typical High
$257.04
Cigna
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$251.19
Typical High
$316.23
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$173.78
Typical High
$275.42
Medcost
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$79.43
Typical High
$302.00
Medcost
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$281.84
Sentara
Setting
Facility
Modifier
Global
Typical Low
$141.25
Median
$199.53
Typical High
$912.01
Sentara
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$199.53
Typical High
$912.01
United
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$208.93
Typical High
$338.84
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$134.90

Where Virginia 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.

Virginia· 3rd of 51

$126

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.