PuraPly wound covering, 1 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 Implant Graft Purified Collagen Matrix Phmb Antimicrobial Puraply 8cm Puraplyam-Com2x4 304568

Payers reporting HCPCS Q4196

Payer pricing summary

Low

Average

$1.1k

Median

$671

High

$5.8k

Payer rate distribution

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#
1	Medicare other · both · +10 other terms	29	$130	$137	$15	11%	48	$116 – $176
2	Anthem fee schedule · outpatient · +24 other terms	95	$125	$2.0k	$6.5k	317%	10–100	$38 – $73.6k
3	Blue Cross Blue Shield fee schedule · outpatient · +28 other terms	297	$171	$551	$2.0k	362%	9–90	$1 – $33.0k
4	UnitedHealthcare fee schedule · outpatient · +29 other terms	566	$210	$482	$1.7k	353%	—	$1 – $32.4k
5	Cigna fee schedule · outpatient · +25 other terms	391	$186	$1.3k	$4.2k	337%	—	$34 – $57.3k
6	Aetna fee schedule · outpatient · +28 other terms	317	$141	$1.4k	$3.7k	254%	—	$20 – $34.7k
7	Humana fee schedule · outpatient · +25 other terms	226	$122	$405	$1.1k	259%	—	$36 – $17.4k
8	Molina fee schedule · outpatient · +23 other terms	113	$191	$414	$1.2k	299%	—	$41 – $13.6k
9	MultiPlan fee schedule · outpatient · +18 other terms	84	$2.8k	$5.9k	$8.6k	146%	—	$92 – $62.0k
10	Caresource fee schedule · outpatient · +14 other terms	72	$174	$233	$217	93%	—	$48 – $918
11	Kaiser fee schedule · outpatient · +19 other terms	71	$264	$3.0k	$5.3k	175%	—	$97 – $43.2k
12	Ambetter facility · fee schedule · outpatient · +16 other terms	60	$218	$244	$235	96%	—	$106 – $4.5k
13	WellCare fee schedule · outpatient · +17 other terms	60	$135	$168	$212	126%	—	$48 – $1.9k
14	Devoted facility · fee schedule · outpatient · +14 other terms	52	$119	$123	$9	7%	—	$111 – $162
15	Tricare facility · fee schedule · outpatient · +13 other terms	48	$127	$169	$329	195%	—	$109 – $3.9k
16	Highmark facility · fee schedule · outpatient · +15 other terms	38	$117	$181	$586	324%	—	$37 – $9.2k
17	First Health fee schedule · outpatient · +18 other terms	36	$3.4k	$7.4k	$9.0k	122%	—	$161 – $54.2k
18	Optum fee schedule · outpatient · +15 other terms	35	$130	$551	$862	157%	—	$108 – $7.2k
19	Medica fee schedule · outpatient · +17 other terms	32	$274	$610	$1.0k	170%	—	$35 – $10.3k
20	Oscar facility · fee schedule · outpatient · +12 other terms	31	$182	$170	$28	17%	—	$122 – $234
21	Bcbs Tx fee schedule · outpatient · +3 other terms	30	$150	$155	$48	31%	—	$114 – $564
22	Phcs fee schedule · outpatient · +10 other terms	26	$1.6k	$1.2k	$1.5k	129%	—	$81 – $8.8k
23	Amerihealth Caritas other · outpatient · +8 other terms	25	$1.8k	$1.9k	$2.2k	117%	—	$57 – $19.5k
24	Baylor Scott White Health Plan facility · fee schedule · outpatient · +2 other terms	25	$158	$158	$31	20%	—	$119 – $207
25	Bcbs La fee schedule · outpatient · +3 other terms	25	$116	$116	$1	0%	—	$116 – $119

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