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Colorado rates for HCPCS Q4204

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

Facilitymedian $182 · 10th–90th $129–$3,7150%20%10th90th$182Professionalmedian $3,715 · 10th–90th $135–$3,8900%50%10th90th$3,715$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,715.35 / $3,715.35 / $3,715.35
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,715.35 / $3,715.35 / $4,073.80
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $457.09 / $457.09
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $457.09 / $3,162.28
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $144.54 / $3,311.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $208.93 / $3,548.13
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $134.90 / $134.90
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $4,786.30 / $8,709.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $2,951.21