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Zenith Amniotic Membrane

Virginia 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?

$126

Typical negotiated rate. In Virginia, July 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 $468 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$126$75.86 to $617
FacilityA hospital or hospital-owned outpatient department$468$79.43 to $741

How much rates vary

Facilitymedian $468 · 10th to 90th $76 to $1,148Professionalmedian $126 · 10th to 90th $76 to $1,023
$50$200$1K$5Kfacility $468professional $126

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
$79.43
Typical High
$79.43
Aetna
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$75.86
Typical High
$616.60
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$616.60
Median
$616.60
Typical High
$1,096.48
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$31.62
Median
$31.62
Typical High
$128.82
Cigna
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$251.19
Typical High
$316.23
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$173.78
Typical High
$1,023.29
Medcost
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$85.11
Typical High
$1,148.15
Medcost
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$75.86
Typical High
$1,071.52
Sentara
Setting
Facility
Modifier
Global
Typical Low
$31.62
Median
$602.56
Typical High
$1,445.44
Sentara
Setting
Professional
Modifier
Global
Typical Low
$31.62
Median
$602.56
Typical High
$1,445.44
United
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$208.93
Typical High
$478.63
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$134.90

Where Virginia 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.

Virginia· 3rd of 51

$126

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.