Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
Xwrap 1 sq cm
Summit, WI
See all hospitals reporting HCPCS Q4204 →Price type
Aurora Medical Center Summit’s median price of $3.6k is 857% above the median hospital's median price ($381), higher than 81% of the 926 hospitals reporting HCPCS Q4204. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 3 payers, 4 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Aetna hmo fee schedule · outpatient | $2.7k | $2.7k | — | — | — | $2.7k – $2.7k |
| 2 | Healthpartners employee trust fund fee schedule · outpatient | $3.5k | $3.5k | — | — | — | $3.5k – $3.5k |
| 3 | Healthpartners robin fee schedule · outpatient | $3.6k | $3.6k | — | — | — | $3.6k – $3.6k |
| 4 | Cigna ppo-gppo fee schedule · outpatient | $4.4k | $4.4k | — | — | — | $4.4k – $4.4k |
Last updated: Nov 21, 2025
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