go back

North Carolina rates for HCPCS Q4204

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

Facilitymedian $501 · 10th–90th $132–$5,4950%10%20%10th90th$501Professionalmedian $3,715 · 10th–90th $89–$3,8900%20%40%10th90th$3,715$1.0$5.0$20.0$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
$457.09 / $457.09 / $457.09
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $3,715.35 / $3,890.45
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $134.90 / $208.93
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $117.49
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $190.55 / $302.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $169.82
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $3,548.13 / $5,370.32
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $316.23
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $194.98 / $245.47
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $3,548.13 / $5,370.32
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $2,951.21
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,317.64 / $8,317.64 / $8,317.64
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12,302.69 / $12,302.69 / $15,848.93