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Amnio Wrap2

Louisiana 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?

$219

Typical negotiated rate. In Louisiana, October 2026.

Insurers have agreed to pay about $219 for this service. The price depends on where it is billed: about $126 from a physician practice, and about $2,089 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 4 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$126$126 to $1,995
FacilityA hospital or hospital-owned outpatient department$2,089$2,089 to $2,089

How much rates vary

Facilitymedian $2,089 · 10th to 90th $339 to $2,089Professionalmedian $126 · 10th to 90th $126 to $2,089
$100$200$500$1K$2Kfacility $2,089professional $126

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
Facility
Modifier
None
Typical Low
$1,949.84
Median
$1,949.84
Typical High
$2,041.74
Aetna
Setting
Professional
Modifier
None
Typical Low
$1,949.84
Median
$1,995.26
Typical High
$2,041.74
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$977.24
Median
$1,000.00
Typical High
$1,000.00
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$389.05
Median
$398.11
Typical High
$407.38
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$295.12
Median
$295.12
Typical High
$302.00
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$194.98
Median
$199.53
Typical High
$204.17
BCBS Louisiana
Setting
Facility
Modifier
None
Typical Low
$2,089.30
Median
$2,089.30
Typical High
$2,089.30
BCBS Louisiana
Setting
Professional
Modifier
None
Typical Low
$2,089.30
Median
$2,089.30
Typical High
$2,089.30
Cigna
Setting
Facility
Modifier
None
Typical Low
$125.89
Median
$239.88
Typical High
$346.74
Cigna
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
United
Setting
Professional
Modifier
None
Typical Low
$117.49
Median
$125.89
Typical High
$134.90

Where Louisiana 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.

Louisiana· 28th of 51

$219

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.