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Dermacyte Amniotic Membrane Allograft

Pennsylvania rates for HCPCS Q4248

Dermacyte Amniotic Membrane Allograft, per sq cm (add-on, list separately in addition to primary procedure)

Rates data updated July 2026.

How much does Dermacyte Amniotic Membrane Allograft cost?

$550

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $550 for this service. The price depends on where it is billed: about $550 from a physician practice, and about $550 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 8 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$550$550 to $575
FacilityA hospital or hospital-owned outpatient department$550$479 to $562

How much rates vary

Facilitymedian $550 · 10th to 90th $178 to $2,239Professionalmedian $550 · 10th to 90th $126 to $776
$200$500$1K$2K$5Kfacility $550professional $550

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
Facility
Modifier
Global
Typical Low
$549.54
Median
$549.54
Typical High
$562.34
Aetna
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$549.54
Typical High
$616.60
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$1,905.46
Median
$2,238.72
Typical High
$2,818.38
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$2,238.72
Median
$2,238.72
Typical High
$2,238.72
Cigna
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$446.68
Typical High
$478.63
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$275.42
Typical High
$1,318.26
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$158.49
Typical High
$223.87
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$549.54
Median
$562.34
Typical High
$562.34
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$549.54
Typical High
$588.84
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$134.90
Median
$134.90
Typical High
$154.88
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$134.90
Typical High
$154.88
United
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$154.88
Typical High
$154.88
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$1,122.02

Where Pennsylvania sits

The same service costs 2.7 times more in South Dakota than in Minnesota. 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.

Pennsylvania· 22nd of 51

$550

SD $692MN $257

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.