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Tennessee rates for HCPCS Q4204

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

Facilitymedian $3,715 · 10th–90th $145–$8,3180%20%10th90th$3,715Professionalmedian $3,715 · 10th–90th $126–$3,8900%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 / $6,456.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,715.35 / $3,715.35 / $3,890.45
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,311.31 / $3,311.31
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $186.21 / $223.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,317.64 / $8,317.64 / $8,317.64
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12,302.69 / $15,848.93 / $15,848.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $4,786.30 / $6,309.57
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $2,951.21