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XWRAP

Minnesota 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?

$234

Typical negotiated rate. In Minnesota, July 2026.

Insurers have agreed to pay about $234 for this service. The price depends on where it is billed: about $151 from a physician practice, and about $4,677 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 6 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$151$115 to $3,020
FacilityA hospital or hospital-owned outpatient department$4,677$2,951 to $7,762

How much rates vary

Facilitymedian $4,677 · 10th to 90th $257 to $9,550Professionalmedian $151 · 10th to 90th $107 to $3,715
$100$200$500$1K$2K$5K$10Kfacility $4,677professional $151

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
$3,715.35
Median
$3,715.35
Typical High
$3,715.35
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
$257.04
Median
$2,951.21
Typical High
$4,677.35
BCBS
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$125.89
Typical High
$2,818.38
Cigna
Setting
Facility
Modifier
Global
Typical Low
$4,570.88
Median
$8,128.31
Typical High
$11,220.18
Cigna
Setting
Professional
Modifier
Global
Typical Low
$3,019.95
Median
$3,388.44
Typical High
$3,890.45
Health Partners
Setting
Facility
Modifier
Global
Typical Low
$5,495.41
Median
$7,762.47
Typical High
$11,481.54
Health Partners
Setting
Professional
Modifier
Global
Typical Low
$3,019.95
Median
$3,019.95
Typical High
$3,890.45
Medica
Setting
Facility
Modifier
Global
Typical Low
$3,801.89
Median
$3,801.89
Typical High
$6,606.93
Medica
Setting
Professional
Modifier
Global
Typical Low
$3,311.31
Median
$3,801.89
Typical High
$5,011.87
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$3,090.30

Where Minnesota 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.

Minnesota· 51st of 51

$234

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.