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North Dakota rates for HCPCS Q4204

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

Facilitymedian $3,715 · 10th–90th $3,715–$6,3100%50%90th$3,715Professionalmedian $3,715 · 10th–90th $3,311–$4,2660%50%10th90th$3,715$100.0$200.0$500.0$1.0K$2.0K$5.0K$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
$3,715.35 / $3,715.35 / $3,715.35
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,715.35 / $3,715.35 / $4,265.80
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,019.95 / $3,467.37 / $4,466.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,786.30 / $4,786.30 / $5,495.41
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $3,019.95 / $3,801.89
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,801.89 / $4,677.35 / $6,606.93
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,951.21 / $3,801.89 / $4,265.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $2,754.23