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Membrane Graft or Membrane Wrap

North Dakota 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?

$1,230

Typical negotiated rate. In North Dakota, July 2026.

Insurers have agreed to pay about $1,230 for this service. The price depends on where it is billed: about $1,230 from a physician practice, and about $1,230 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 5 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$1,230$1,148 to $1,349
FacilityA hospital or hospital-owned outpatient department$1,230$1,230 to $1,230

How much rates vary

Facilitymedian $1,230 · 10th to 90th $1,202 to $1,950Professionalmedian $1,230 · 10th to 90th $1,000 to $1,479
$100$200$500$1K$2K$5Kfacility $1,230professional $1,230

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
$2,290.87
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,000.00
Median
$1,148.15
Typical High
$1,479.11
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,698.24
Median
$1,698.24
Typical High
$1,949.84
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$1,071.52
Typical High
$1,348.96
Medica
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$1,412.54
Typical High
$2,238.72
Medica
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,202.26
Typical High
$1,318.26
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$398.11

Where North Dakota 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.

North Dakota· 48th of 51

$1,230

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.