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XWRAP

Arizona 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?

$3,715

Typical negotiated rate. In Arizona, July 2026.

Insurers have agreed to pay about $3,715 for this service. The price depends on where it is billed: about $3,715 from a physician practice, and about $170 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 5 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$3,715$457 to $3,802
FacilityA hospital or hospital-owned outpatient department$170$79.43 to $407

How much rates vary

Facilitymedian $170 · 10th to 90th $59 to $4,467Professionalmedian $3,715 · 10th to 90th $126 to $4,074
$50$200$1K$5Kfacility $170professional $3,715

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
Facility
Modifier
Global
Typical Low
$4,073.80
Median
$4,073.80
Typical High
$4,073.80
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3,715.35
Median
$3,715.35
Typical High
$4,073.80
BCBS
Setting
Facility
Modifier
Global
Typical Low
$53.70
Median
$97.72
Typical High
$331.13
BCBS
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$138.04
Typical High
$234.42
Cigna
Setting
Facility
Modifier
Global
Typical Low
$131.83
Median
$223.87
Typical High
$251.19
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Medica
Setting
Facility
Modifier
Global
Typical Low
$3,715.35
Median
$4,168.69
Typical High
$8,511.38
Medica
Setting
Professional
Modifier
Global
Typical Low
$3,801.89
Median
$3,801.89
Typical High
$4,073.80
United
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$125.89
Typical High
$125.89
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89

Where Arizona 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.

Arizona· 29th of 51

$3,715

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.