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Connecticut rates for HCPCS Q4204

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

Facilitymedian $3,802 · 10th–90th $145–$6,1660%20%10th90th$3,802Professionalmedian $3,715 · 10th–90th $457–$4,0740%50%10th90th$3,715$100.0$500.0$2.0K$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
$3,801.89 / $6,165.95 / $6,165.95
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,715.35 / $3,715.35 / $4,073.80
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $3,162.28 / $3,890.45
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $144.54 / $245.47
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
ConnectiCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $2,884.03 / $3,890.45
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,905.46 / $1,905.46
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $125.89 / $4,786.30