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XWRAP

Alaska rates for HCPCS Q4204

XWRAP, per sq cm (add-on, list separately in addition to primary procedure)

Rates data updated July 2026.

How much does XWRAP cost?

$3,388

Typical negotiated rate. In Alaska, July 2026.

Insurers have agreed to pay about $3,388 for this service. The price depends on where it is billed: about $537 from a physician practice, and about $3,802 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 6 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$537$295 to $3,715
FacilityA hospital or hospital-owned outpatient department$3,802$3,715 to $5,495

How much rates vary

Facilitymedian $3,802 · 10th to 90th $178 to $7,586Professionalmedian $537 · 10th to 90th $195 to $4,571
$200$500$1K$2K$5K$10Kfacility $3,802professional $537

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
Professional
Modifier
Global
Typical Low
$3,715.35
Median
$3,715.35
Typical High
$6,918.31
Cigna
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$3,801.89
Typical High
$6,918.31
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$309.03
Typical High
$512.86
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$4,786.30
Median
$4,786.30
Typical High
$7,585.78
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$3,388.44
Median
$3,801.89
Typical High
$4,073.80
Providence
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$3,801.89
Typical High
$6,918.31
Providence
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$125.89
Typical High
$3,548.13
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$190.55
Typical High
$630.96

Where Alaska sits

The same service costs 16.2 times more in Kansas than in Minnesota. 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.

Alaska· 47th of 51

$3,388

KS $3,802MN $234

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.