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Colorado rates for HCPCS Q4204

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,692.14 / $3,692.14 / $3,774.77
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,692.14 / $3,692.14 / $3,802.91
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$459.00 / $459.00 / $459.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$459.00 / $459.00 / $459.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,483.15 / $3,483.15 / $3,692.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,692.14 / $3,692.14 / $3,692.14
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,774.77 / $3,913.67 / $6,085.76
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,024.43 / $4,061.36 / $4,984.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,692.14 / $3,692.14 / $3,692.14