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Amnio Wrap2

Alaska rates for HCPCS Q4221

Amnio Wrap2, per sq cm (add-on, list separately in addition to primary procedure)

Rates data updated October 2026.

How much does Amnio Wrap2 cost?

$2,291

Typical negotiated rate. In Alaska, October 2026.

Insurers have agreed to pay about $2,291 for this service. The price depends on where it is billed: about $2,291 from a physician practice, and about $3,631 from a hospital or other facility.

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.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$2,291$257 to $3,631
FacilityA hospital or hospital-owned outpatient department$3,631$1,950 to $4,786

How much rates vary

Facilitymedian $3,631 · 10th to 90th $186 to $5,248Professionalmedian $2,291 · 10th to 90th $191 to $3,631
$200$500$1K$2K$5Kfacility $3,631professional $2,291

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$3,630.78
Median
$3,630.78
Typical High
$3,630.78
Aetna
Setting
Professional
Modifier
None
Typical Low
$2,041.74
Median
$3,630.78
Typical High
$3,630.78
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$1,000.00
Median
$1,819.70
Typical High
$1,819.70
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$407.38
Median
$724.44
Typical High
$724.44
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$302.00
Median
$549.54
Typical High
$549.54
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$204.17
Median
$363.08
Typical High
$363.08
Cigna
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Moda Health
Setting
Facility
Modifier
None
Typical Low
$1,949.84
Median
$3,630.78
Typical High
$5,248.07
Moda Health
Setting
Professional
Modifier
None
Typical Low
$257.04
Median
$1,995.26
Typical High
$3,630.78
Moda Health
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$1,819.70
Median
$1,819.70
Typical High
$1,819.70
Moda Health
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$724.44
Median
$724.44
Typical High
$724.44
Moda Health
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$549.54
Median
$549.54
Typical High
$549.54
Moda Health
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$363.08
Median
$363.08
Typical High
$363.08
Premera BCBS
Setting
Facility
Modifier
None
Typical Low
$3,388.44
Median
$3,801.89
Typical High
$5,248.07
Premera BCBS
Setting
Professional
Modifier
None
Typical Low
$2,290.87
Median
$2,398.83
Typical High
$2,884.03
Providence
Setting
Facility
Modifier
None
Typical Low
$128.82
Median
$128.82
Typical High
$186.21
Providence
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$2,511.89
United
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$190.55
Typical High
$354.81

Where Alaska sits

The same service costs 19.5 times more in Alaska than in North Carolina. 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.

Alaska· 1st of 51

$2,291

AK $2,291NC $117

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.