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AmnioBand or Guardian

Pennsylvania rates for HCPCS Q4151

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

Rates data updated July 2026.

How much does AmnioBand or Guardian cost?

$135

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $135 for this service. The price depends on where it is billed: about $135 from a physician practice, and about $135 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 9 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$135$135 to $135
FacilityA hospital or hospital-owned outpatient department$135$135 to $145

How much rates vary

Facilitymedian $135 · 10th to 90th $126 to $468Professionalmedian $135 · 10th to 90th $126 to $148
$100$500$2K$10K$50Kfacility $135professional $135

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
$134.90
Median
$134.90
Typical High
$134.90
Aetna
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$134.90
Typical High
$141.25
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$134.90
Typical High
$8,511.38
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$134.90
Typical High
$134.90
Cigna
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$446.68
Typical High
$478.63
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$147.91
Typical High
$263.03
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$151.36
Typical High
$218.78
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,148.15
Median
$1,148.15
Typical High
$1,148.15
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$134.90
Median
$134.90
Typical High
$134.90
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$134.90
Typical High
$141.25
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$120.23
Typical High
$141.25
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$120.23
Typical High
$141.25
United
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$154.88
Typical High
$154.88
United
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$125.89
Typical High
$154.88

Where Pennsylvania sits

The same service costs 1.6 times more in Alaska 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.

Pennsylvania· 26th of 51

$135

AK $204MN $126

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.