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AmnioText Patch

Utah rates for HCPCS Q4247

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

Rates data updated October 2026.

How much does AmnioText Patch cost?

$126

Typical negotiated rate. In Utah, 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 $3,020 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 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$126$126 to $145
FacilityA hospital or hospital-owned outpatient department$3,020$3,020 to $3,020

How much rates vary

Facilitymedian $3,020 · 10th to 90th $447 to $3,020Professionalmedian $126 · 10th to 90th $126 to $3,020
$200$500$1K$2Kfacility $3,020professional $126

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
$3,019.95
Median
$3,019.95
Typical High
$3,019.95
Aetna
Setting
Professional
Modifier
None
Typical Low
$3,019.95
Median
$3,019.95
Typical High
$3,019.95
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$1,513.56
Median
$1,513.56
Typical High
$1,513.56
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$616.60
Median
$616.60
Typical High
$616.60
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$457.09
Median
$457.09
Typical High
$457.09
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$302.00
Median
$302.00
Typical High
$302.00
Cigna
Setting
Facility
Modifier
None
Typical Low
$446.68
Median
$446.68
Typical High
$446.68
Cigna
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Molina
Setting
Professional
Modifier
None
Typical Low
$30.20
Median
$30.20
Typical High
$30.20
Regence BlueShield
Setting
Professional
Modifier
None
Typical Low
$123.03
Median
$131.83
Typical High
$151.36
Select Health
Setting
Facility
Modifier
None
Typical Low
$120.23
Median
$120.23
Typical High
$120.23
Select Health
Setting
Professional
Modifier
None
Typical Low
$120.23
Median
$120.23
Typical High
$151.36
U of Utah Health Plan
Setting
Professional
Modifier
None
Typical Low
$83.18
Median
$169.82
Typical High
$295.12
United
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$125.89

Where Utah sits

The same service costs 26.9 times more in Wyoming 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.

Utah· 49th of 51

$126

WY $3,162NC $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.