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Amnio Wrap2

Arizona 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?

$191

Typical negotiated rate. In Arizona, October 2026.

Insurers have agreed to pay about $191 for this service. The price depends on where it is billed: about $240 from a physician practice, and about $166 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 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$240$126 to $2,138
FacilityA hospital or hospital-owned outpatient department$166$67.61 to $234

How much rates vary

Facilitymedian $166 · 10th to 90th $49 to $339Professionalmedian $240 · 10th to 90th $107 to $2,138
$50$100$200$500$1K$2K$5Kfacility $166professional $240

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$2,041.74
Median
$2,137.96
Typical High
$2,137.96
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$1,023.29
Median
$1,071.52
Typical High
$1,071.52
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$407.38
Median
$426.58
Typical High
$426.58
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$309.03
Median
$323.59
Typical High
$323.59
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$204.17
Median
$213.80
Typical High
$213.80
BCBS Arizona
Setting
Facility
Modifier
None
Typical Low
$48.98
Median
$117.49
Typical High
$309.03
BCBS Arizona
Setting
Professional
Modifier
None
Typical Low
$97.72
Median
$100.00
Typical High
$223.87
Cigna
Setting
Facility
Modifier
None
Typical Low
$158.49
Median
$223.87
Typical High
$234.42
Cigna
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Medica
Setting
Facility
Modifier
None
Typical Low
$1,905.46
Median
$2,398.83
Typical High
$3,090.30
Medica
Setting
Professional
Modifier
None
Typical Low
$1,949.84
Median
$1,949.84
Typical High
$6,760.83
United
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$125.89

Where Arizona 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.

Arizona· 31st of 51

$191

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.