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Amnio Wrap2

Michigan 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?

$2,042

Typical negotiated rate. In Michigan, October 2026.

Insurers have agreed to pay about $2,042 for this service. The price depends on where it is billed: about $2,042 from a physician practice, and about $2,042 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$2,042$126 to $2,042
FacilityA hospital or hospital-owned outpatient department$2,042$135 to $5,248

How much rates vary

Facilitymedian $2,042 · 10th to 90th $135 to $5,754Professionalmedian $2,042 · 10th to 90th $120 to $2,291
$200$500$1K$2K$5Kfacility $2,042professional $2,042

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
$2,041.74
Median
$2,041.74
Typical High
$2,041.74
Aetna
Setting
Professional
Modifier
None
Typical Low
$2,041.74
Median
$2,041.74
Typical High
$2,041.74
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$1,000.00
Median
$1,000.00
Typical High
$1,023.29
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$407.38
Median
$407.38
Typical High
$407.38
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$302.00
Median
$302.00
Typical High
$309.03
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$204.17
Median
$204.17
Typical High
$204.17
BCBS Michigan
Setting
Facility
Modifier
None
Typical Low
$120.23
Median
$120.23
Typical High
$120.23
BCBS Michigan
Setting
Professional
Modifier
None
Typical Low
$112.20
Median
$120.23
Typical High
$120.23
Cigna
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$199.53
Health Alliance Plan
Setting
Facility
Modifier
None
Typical Low
$134.90
Median
$2,041.74
Typical High
$5,754.40
Health Alliance Plan
Setting
Professional
Modifier
None
Typical Low
$1,949.84
Median
$2,041.74
Typical High
$2,570.40
Health Alliance Plan
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$1,000.00
Median
$1,000.00
Typical High
$1,000.00
Health Alliance Plan
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$407.38
Median
$407.38
Typical High
$407.38
Health Alliance Plan
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$302.00
Median
$302.00
Typical High
$302.00
Health Alliance Plan
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$204.17
Median
$204.17
Typical High
$204.17
Priority Health
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$181.97
United
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$134.90

Where Michigan 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.

Michigan· 4th of 51

$2,042

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.