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Amnio Wrap2

Virginia 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?

$1,905

Typical negotiated rate. In Virginia, October 2026.

Insurers have agreed to pay about $1,905 for this service. The price depends on where it is billed: about $1,905 from a physician practice, and about $1,698 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 8 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$1,905$126 to $1,950
FacilityA hospital or hospital-owned outpatient department$1,698$316 to $2,455

How much rates vary

Facilitymedian $1,698 · 10th to 90th $224 to $7,413Professionalmedian $1,905 · 10th to 90th $126 to $2,042
$100$200$500$1K$2K$5K$10Kfacility $1,698professional $1,905

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
$2,041.74
Typical High
$2,041.74
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$977.24
Median
$1,023.29
Typical High
$1,023.29
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$389.05
Median
$407.38
Typical High
$407.38
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$295.12
Median
$309.03
Typical High
$309.03
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$194.98
Median
$204.17
Typical High
$204.17
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$1,905.46
Median
$1,905.46
Typical High
$1,905.46
CareFirst
Setting
Professional
Modifier
None
Typical Low
$1,949.84
Median
$1,949.84
Typical High
$1,949.84
Cigna
Setting
Facility
Modifier
None
Typical Low
$190.55
Median
$239.88
Typical High
$331.13
Cigna
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$158.49
Typical High
$2,137.96
Medcost
Setting
Facility
Modifier
None
Typical Low
$1,949.84
Median
$1,949.84
Typical High
$3,162.28
Medcost
Setting
Professional
Modifier
None
Typical Low
$109.65
Median
$109.65
Typical High
$2,290.87
Sentara
Setting
Facility
Modifier
None
Typical Low
$851.14
Median
$2,041.74
Typical High
$10,232.93
Sentara
Setting
Professional
Modifier
None
Typical Low
$1,174.90
Median
$1,659.59
Typical High
$3,090.30
United
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$134.90

Where Virginia 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.

Virginia· 23rd of 51

$1,905

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.