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AmnioText Patch

Wisconsin rates for HCPCS Q4247

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

Rates data updated July 2026.

Facilitymedian $1,738 · 10th–90th $389$5,3700%10%10th90th$1,738Professionalmedian $832 · 10th–90th $126$3,2360%10%20%10th90th$832$5.0$20.0$100.0$500.0$2.0K$10.0K

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
$2,951.21
Median
$2,951.21
Typical High
$2,951.21
Aetna
Setting
Professional
Modifier
Global
Typical Low
$2,951.21
Median
$2,951.21
Typical High
$3,715.35
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$676.08
Typical High
$1,174.90
Cigna
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$1,479.11
Typical High
$2,187.76
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$223.87
Typical High
$676.08
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$524.81
Median
$2,951.21
Typical High
$4,466.84
Medica
Setting
Facility
Modifier
Global
Typical Low
$524.81
Median
$1,348.96
Typical High
$2,398.83
Medica
Setting
Professional
Modifier
Global
Typical Low
$3,235.94
Median
$3,235.94
Typical High
$5,011.87
Molina
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$60.26
Typical High
$70.79
Network Health
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$562.34
Typical High
$562.34
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$524.81
Median
$2,951.21
Typical High
$4,466.84
Quartz
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$302.00
Typical High
$1,071.52
Quartz
Setting
Facility
Modifier
Global
Typical Low
$3,162.28
Median
$3,162.28
Typical High
$7,413.10
Quartz
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$660.69
Typical High
$10,964.78
Security Health
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$147.91
Typical High
$147.91
Security Health
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$707.95
Typical High
$870.96
United
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$295.12
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$169.82