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Amnio Wrap2

Montana rates for HCPCS Q4221

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

Rates data updated July 2026.

How much does Amnio Wrap2 cost?

$2,042

Typical negotiated rate. In Montana, July 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 $1,950 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$2,042$1,778 to $2,138
FacilityA hospital or hospital-owned outpatient department$1,950$1,778 to $2,291

How much rates vary

Facilitymedian $1,950 · 10th to 90th $1,698 to $2,570Professionalmedian $2,042 · 10th to 90th $126 to $2,291
$100.0$200.0$500.0$1.0K$2.0K$5.0Kfacility $1,950professional $2,042

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,949.84
Median
$2,137.96
Typical High
$2,454.71
Cigna
Setting
Facility
Modifier
Global
Typical Low
$204.17
Median
$2,290.87
Typical High
$2,290.87
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$181.97
Typical High
$2,290.87
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$1,778.28
Median
$1,778.28
Typical High
$2,570.40
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$1,778.28
Median
$1,778.28
Typical High
$2,570.40
Providence
Setting
Facility
Modifier
Global
Typical Low
$204.17
Median
$1,995.26
Typical High
$2,511.89
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$125.89
Typical High
$2,511.89
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89

Where Montana sits

The same service costs 8.7 times more in California than in Minnesota. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Montana $2,042 · 2nd of 51
CA $2,042MN $234

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.