go back

Zenith Amniotic Membrane

Michigan rates for HCPCS Q4253

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

Rates data updated July 2026.

How much does Zenith Amniotic Membrane cost?

$77.62

Typical negotiated rate. In Michigan, July 2026.

Insurers have agreed to pay about $77.62 for this service. The price depends on where it is billed: about $77.62 from a physician practice, and about $102 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 6 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$77.62$75.86 to $126
FacilityA hospital or hospital-owned outpatient department$102$77.62 to $126

How much rates vary

Facilitymedian $102 · 10th to 90th $78 to $1,288Professionalmedian $78 · 10th to 90th $76 to $135
$100$200$500$1K$2Kfacility $102professional $78

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
$77.62
Median
$77.62
Typical High
$77.62
Aetna
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$75.86
Typical High
$79.43
BCBS
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
BCBS
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$125.89
Typical High
$134.90
Cigna
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$125.89
Typical High
$125.89
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$1,202.26
Median
$1,288.25
Typical High
$3,548.13
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$144.54
Typical High
$1,548.82
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$77.62
Typical High
$199.53
United
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$1,148.15
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$134.90

Where Michigan sits

The same service costs 2.5 times more in Alaska than in Maryland. 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.

Michigan· 25th of 51

$77.62

AK $191MD $75.86

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.