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XWRAP

Montana 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?

$3,715

Typical negotiated rate. In Montana, July 2026.

Insurers have agreed to pay about $3,715 for this service. Most negotiated rates run $3,311 to $4,074.

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 4 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $3,311 · 10th to 90th $204 to $4,467Professionalmedian $3,715 · 10th to 90th $126 to $4,266
$100$200$500$1K$2K$5Kfacility $3,311professional $3,715

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
Professional
Modifier
Global
Typical Low
$3,715.35
Median
$3,981.07
Typical High
$4,265.80
Cigna
Setting
Facility
Modifier
Global
Typical Low
$204.17
Median
$3,311.31
Typical High
$3,311.31
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$181.97
Typical High
$3,311.31
Providence
Setting
Facility
Modifier
Global
Typical Low
$204.17
Median
$3,548.13
Typical High
$4,570.88
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$125.89
Typical High
$3,548.13
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89

Where Montana 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.

Montana· 35th of 51

$3,715

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.