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Amnio Wrap2

Missouri 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?

$126

Typical negotiated rate. In Missouri, October 2026.

Insurers have agreed to pay about $126 for this service. The price depends on where it is billed: about $126 from a physician practice, and about $282 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$126$110 to $1,778
FacilityA hospital or hospital-owned outpatient department$282$219 to $2,188

How much rates vary

Facilitymedian $282 · 10th to 90th $182 to $6,607Professionalmedian $126 · 10th to 90th $110 to $2,042
$100$200$500$1K$2K$5Kfacility $282professional $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
$2,041.74
Typical High
$2,041.74
Aetna
Setting
Professional
Modifier
None
Typical Low
$1,949.84
Median
$2,041.74
Typical High
$2,344.23
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$97.72
Median
$109.65
Typical High
$1,584.89
BCBS Kansas City
Setting
Professional
Modifier
None
Typical Low
$120.23
Median
$138.04
Typical High
$181.97
Cigna
Setting
Facility
Modifier
None
Typical Low
$144.54
Median
$223.87
Typical High
$371.54
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
$2,691.53
Typical High
$6,606.93
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
$114.82
Median
$125.89
Typical High
$147.91
4 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$977.24
Median
$1,000.00
Typical High
$1,174.90
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$389.05
Median
$407.38
Typical High
$467.74
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$295.12
Median
$302.00
Typical High
$354.81
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$194.98
Median
$204.17
Typical High
$234.42

Where Missouri 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.

Missouri· 46th of 51

$126

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.