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Zenith Amniotic Membrane

Missouri 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?

$97.72

Typical negotiated rate. In Missouri, July 2026.

Insurers have agreed to pay about $97.72 for this service. The price depends on where it is billed: about $97.72 from a physician practice, and about $126 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$97.72$77.62 to $126
FacilityA hospital or hospital-owned outpatient department$126$85.11 to $437

How much rates vary

Facilitymedian $126 · 10th to 90th $78 to $1,202Professionalmedian $98 · 10th to 90th $76 to $417
$100$200$500$1K$2Kfacility $126professional $98

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
$75.86
Median
$77.62
Typical High
$1,202.26
Aetna
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$75.86
Typical High
$141.25
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$109.65
Typical High
$501.19
BCBS
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$144.54
Typical High
$194.98
Cigna
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$239.88
Typical High
$380.19
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$144.54
Medica
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$117.49
Typical High
$1,148.15
Medica
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$83.18
Typical High
$1,318.26
United
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$125.89
Typical High
$1,548.82
United
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$125.89
Typical High
$154.88

Where Missouri 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.

Missouri· 6th of 51

$97.72

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.