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.
Original text from hospital filings
Puraply xt 1 sq cm
Summit, WI
See all hospitals reporting HCPCS Q4197 →Price type
Aurora Medical Center Summit’s median price of $98 is 33% below the median hospital's median price ($147), higher than 16% of the 1,114 hospitals reporting HCPCS Q4197. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 4 payers, 5 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Aetna hmo fee schedule · outpatient | $75 | $75 | — | — | — | $75 – $75 |
| 2 | Healthpartners employee trust fund fee schedule · outpatient | $85 | $85 | — | — | — | $85 – $85 |
| 3 | Healthpartners robin fee schedule · outpatient | $89 | $89 | — | — | — | $89 – $89 |
| 4 | Cigna ppo-gppo fee schedule · outpatient | $109 | $109 | — | — | — | $109 – $109 |
| 5 | Molina commercial fee schedule · outpatient | $177 | $177 | — | — | — | $177 – $177 |
Last updated: Nov 21, 2025
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