go back

Membrane Graft or Membrane Wrap

Minnesota rates for HCPCS Q4205

Membrane Graft or Membrane Wrap, per sq cm (add-on, list separately in addition to primary procedure)

Rates data updated July 2026.

How much does Membrane Graft or Membrane Wrap 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 $182 from a physician practice, and about $1,738 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$182$115 to $1,072
FacilityA hospital or hospital-owned outpatient department$1,738$1,047 to $2,754

How much rates vary

Facilitymedian $1,738 · 10th to 90th $257 to $3,548Professionalmedian $182 · 10th to 90th $107 to $1,230
$100$200$500$1K$2K$5Kfacility $1,738professional $182

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
$1,230.27
Median
$1,230.27
Typical High
$1,230.27
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,230.27
Median
$1,230.27
Typical High
$1,348.96
BCBS
Setting
Facility
Modifier
Global
Typical Low
$257.04
Median
$1,047.13
Typical High
$1,737.80
BCBS
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$125.89
Typical High
$977.24
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,621.81
Median
$2,818.38
Typical High
$3,890.45
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,071.52
Median
$1,174.90
Typical High
$1,380.38
Health Partners
Setting
Facility
Modifier
Global
Typical Low
$1,949.84
Median
$2,754.23
Typical High
$4,073.80
Health Partners
Setting
Professional
Modifier
Global
Typical Low
$1,071.52
Median
$1,071.52
Typical High
$1,318.26
Medica
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$107.15
Typical High
$1,862.09
Medica
Setting
Professional
Modifier
Global
Typical Low
$1,148.15
Median
$1,202.26
Typical High
$1,584.89
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$1,230.27

Where Minnesota sits

The same service costs 5.6 times more in Montana 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

MT $1,318MN $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.