go back

Amnio Wrap2

Texas rates for HCPCS Q4221

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

Rates data updated July 2026.

Facilitymedian $1,950 · 10th–90th $10$4,1690%10%20%10th90th$1,950Professionalmedian $1,950 · 10th–90th $126$2,0420%20%10th90th$1,950$2.0$10.0$50.0$200.0$1.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1,949.84
Median
$1,995.26
Typical High
$2,454.71
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,949.84
Median
$1,949.84
Typical High
$2,137.96
BCBS
Setting
Facility
Modifier
Global
Typical Low
$8.13
Median
$11.22
Typical High
$32.36
BCBS
Setting
Professional
Modifier
Global
Typical Low
$8.13
Median
$8.13
Typical High
$8.13
Christus
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$120.23
Typical High
$1,949.84
Cigna
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$316.23
Typical High
$851.14
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$5,754.40
Median
$5,754.40
Typical High
$5,754.40
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$6,456.54
Median
$8,317.64
Typical High
$8,317.64
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$1,949.84
Typical High
$3,630.78
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$190.55
Typical High
$234.42
Molina
Setting
Professional
Modifier
Global
Typical Low
$33.11
Median
$1,949.84
Typical High
$1,995.26
Providence
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$1,949.84
Typical High
$3,548.13
Providence
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
United
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$125.89
Typical High
$208.93
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$120.23
Typical High
$169.82