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
HC Puraply Am 1 Sq Cm
Falls, MT
See all hospitals reporting HCPCS Q4196 →Price type
Benefis Hospitals Inc’s median price of $369 is 76% above the median hospital's median price ($210), higher than 73% of the 1,839 hospitals reporting HCPCS Q4196. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 11 payers, 25 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.
Filter by billing methodology
Filter by billing class
| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Cigna bhs hb allegiance fee schedule · outpatient | $120 | $120 | — | — | — | $120 – $120 |
| 2 | Healthpartners bhs hb allegiance fee schedule · outpatient | $120 | $120 | — | — | — | $120 – $120 |
| 3 | Kaiser bhs hb allegiance fee schedule · outpatient | $120 | $120 | — | — | — | $120 – $120 |
| 4 | Medical Mutual bhs hb allegiance fee schedule · outpatient | $120 | $120 | — | — | — | $120 – $120 |
| 5 | Aetna bhs hb medicare other · outpatient | $127 | $127 | — | — | — | $127 – $127 |
| 6 | Anthem bhs hb medicare other · outpatient | $127 | $127 | — | — | — | $127 – $127 |
| 7 | Blue Cross Blue Shield bhs hb medicare other · outpatient | $127 | $127 | — | — | — | $127 – $127 |
| 8 | Kaiser bhs hb medicare other · outpatient | $127 | $127 | — | — | — | $127 – $127 |
| 9 | Medicare bhs hb medicare other · outpatient | $127 | $127 | — | — | — | $127 – $127 |
| 10 | WellCare bhs hb medicare other · outpatient | $127 | $127 | — | — | — | $127 – $127 |
| 11 | Blue Cross Blue Shield bhs hb bcbs blue focus percent of total billed charges · outpatientfrom % of charges | $2.6k | $3.4k | $2.9k | 87% | — | $142 – $8.0k |
| 12 | Blue Cross Blue Shield bhs hb bcbs blue options percent of total billed charges · outpatientfrom % of charges | $2.8k | $3.5k | $3.1k | 87% | — | $150 – $8.5k |
| 13 | Blue Cross Blue Shield bhs hb bcbs employee health plan percent of total billed charges · bothfrom % of charges | $3.0k | $3.9k | $3.4k | 87% | — | $164 – $9.3k |
| 14 | Blue Cross Blue Shield bhs hb bcbs blue focus percent of total billed charges · inpatientfrom % of charges | $3.2k | $4.1k | $3.6k | 87% | — | $175 – $9.9k |
| 15 | Blue Cross Blue Shield bhs hb bcbs blue options percent of total billed charges · inpatientfrom % of charges | $3.3k | $4.2k | $3.7k | 87% | — | $178 – $10.1k |
| 16 | Blue Cross Blue Shield bhs hb bcbs federal percent of total billed charges · bothfrom % of charges | $3.4k | $4.4k | $3.8k | 87% | — | $186 – $10.5k |
| 17 | Blue Cross Blue Shield bhs hb bcbs healthy montana kids percent of total billed charges · bothfrom % of charges | $3.4k | $4.4k | $3.8k | 87% | — | $186 – $10.5k |
| 18 | Blue Cross Blue Shield bhs hb bcbs healthlink ppo percent of total billed charges · bothfrom % of charges | $3.5k | $4.4k | $3.9k | 87% | — | $188 – $10.6k |
| 19 | Cigna bhs hb allegiance percent of total billed charges · inpatientfrom % of charges | $3.6k | $4.7k | $4.1k | 87% | — | $197 – $11.1k |
| 20 | Healthpartners bhs hb allegiance percent of total billed charges · inpatientfrom % of charges | $3.6k | $4.7k | $4.1k | 87% | — | $197 – $11.1k |
| 21 | Kaiser bhs hb allegiance percent of total billed charges · inpatientfrom % of charges | $3.6k | $4.7k | $4.1k | 87% | — | $197 – $11.1k |
| 22 | Medical Mutual bhs hb allegiance percent of total billed charges · inpatientfrom % of charges | $3.6k | $4.7k | $4.1k | 87% | — | $197 – $11.1k |
| 23 | Aetna bhs hb first choice health percent of total billed charges · bothfrom % of charges | $3.7k | $4.8k | $4.1k | 87% | — | $201 – $11.4k |
| 24 | First Health bhs hb first choice health percent of total billed charges · bothfrom % of charges | $3.7k | $4.8k | $4.1k | 87% | — | $201 – $11.4k |
| 25 | UnitedHealthcare bhs hb united healthcare percent of total billed charges · bothfrom % of charges | $3.8k | $4.9k | $4.3k | 87% | — | $208 – $11.7k |
Last updated: Mar 26, 2026
See PuraPly wound covering, 1 square centimeter pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.