Puraply skin substitute, per square centimeter

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

HC (SUP SHELL Q4172) PURAPLY OR PURAPLY AM

Payers reporting HCPCS Q4172

Payer pricing summary

Low

$31

Average

$902

Median

$224

High

$7.9k

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	Humana fee schedule · outpatient · +3 other terms	32	$509	$616	$91	15%	—	$509 – $693
2	Blue Cross Blue Shield fee schedule · outpatient · +6 other terms	16	$199	$248	$110	44%	—	$149 – $509
3	Highmark fee schedule · outpatient · +5 other terms	10	$88	$88	$2	2%	—	$83 – $89
4	MultiPlan fee schedule · inpatient · +8 other terms	6	$257	$257	$41	16%	—	$219 – $315
5	Phcs fee schedule · inpatient · +1 other terms	6	$215	$215	$35	16%	—	$183 – $263
6	UnitedHealthcare fee schedule · outpatient · +9 other terms	6	$138	$144	$87	61%	—	$36 – $274
7	Medica fee schedule · outpatient	5	$227	$227	$36	16%	—	$193 – $278
8	Sanford Health Plan fee schedule · outpatient · +1 other terms	3	$78	$78	—	—	—	$78 – $78
9	Aetna other · outpatient · +10 other terms	2	$116	$116	$64	55%	—	$66 – $225
10	Anthem fee schedule · outpatient · +3 other terms	2	$1.3k	$1.3k	—	—	—	$1.3k – $1.3k
11	Carefirst percent of total billed charges · bothfrom % of charges	2	$90	$90	—	—	—	$90 – $90
12	Cigna fee schedule · both · +8 other terms	2	$92	$89	$9	10%	—	$77 – $99
13	First Health facility · percent of total billed charges · outpatientfrom % of charges · +3 other terms	2	$6.9k	$9.2k	$6.5k	71%	—	$301 – $15.6k
14	Molina facility · fee schedule · outpatient · +2 other terms	2	$111	$111	$18	16%	—	$93 – $129
15	Optum other · outpatient · +2 other terms	2	$241	$241	$40	16%	—	$201 – $280
16	Aetna Better Health other · outpatient	1	$31	$31	—	—	—	$31 – $31
17	Ambetter other · outpatient	1	$84	$84	—	—	—	$84 – $84
18	Amerihealth Caritas other · outpatient · +2 other terms	1	$31	$31	—	—	—	$31 – $31
19	Bcbs Id professional · fee schedule · outpatient	1	$105	$105	—	—	—	$105 – $105
20	Bcbs La other · outpatient · +1 other terms	1	$101	$101	—	—	—	$101 – $101
21	Bcbs Ms other · outpatient	1	$217	$217	$7	3%	—	$210 – $224
22	Devoted facility · other · outpatient	1	$92	$92	$3	3%	—	$90 – $95
23	Healthpartners facility · fee schedule · outpatient	1	$224	$224	—	—	—	$224 – $224
24	Kaiser facility · fee schedule · outpatient · +3 other terms	1	$380	$380	—	—	—	$380 – $380
25	Magellan facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms	1	$231	$231	$7	3%	—	$224 – $237

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