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Iowa rates for HCPCS Q4204

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

Facilitymedian $3,715 · 10th–90th $3,715–$3,7150%50%$3,715Professionalmedian $3,715 · 10th–90th $457–$4,0740%50%10th90th$3,715$0.2$2.0$20.0$200.0$2.0K

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
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $245.47 / $302.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $3,090.30 / $3,801.89
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $2,570.40 / $3,715.35
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,388.44 / $3,801.89 / $6,606.93
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,548.13 / $3,801.89 / $6,606.93
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $3,548.13 / $4,570.88
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $245.47 / $302.00
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $588.84 / $588.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.95 / $2,951.21 / $4,786.30
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $2,951.21
Wellmark
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,715.35 / $3,715.35 / $3,715.35
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,715.35 / $3,715.35 / $3,715.35