Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
Amniowrap2 per sq cm
Kettering, OH
See all hospitals reporting HCPCS Q4221 →Price type
Kettering Medical Center ’s median price of $293 is 23% below the median hospital's median price ($381), higher than 47% of the 915 hospitals reporting HCPCS Q4221. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 7 payers, 12 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
Filter by billing methodology
Filter by billing class
| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Aetna medicare managed care plan fee schedule · outpatient | $123 | $123 | — | — | — | $123 – $123 |
| 2 | Molina medicare managed care plan fee schedule · outpatient | $129 | $129 | — | — | — | $129 – $129 |
| 3 | Blue Cross Blue Shield anthem pathway hmox exchange fee schedule · outpatient | $183 | $183 | — | — | — | $183 – $183 |
| 4 | Caresource marketplace exchange fee schedule · outpatient | $190 | $190 | — | — | — | $190 – $190 |
| 5 | UnitedHealthcare exchange fee schedule · outpatient | $190 | $190 | — | — | — | $190 – $190 |
| 6 | Molina exchange fee schedule · outpatient | $255 | $255 | — | — | — | $255 – $255 |
| 7 | Blue Cross Blue Shield anthem - blue access/blue preferred hmo/ppo fee schedule · outpatient | $423 | $423 | — | — | — | $423 – $423 |
| 8 | UnitedHealthcare all commercial plans fee schedule · outpatient | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
| 9 | UnitedHealthcare employee fee schedule · outpatient | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
| 10 | Medical Mutual new buisness other commercial plan fee schedule · outpatient | $2.7k | $2.7k | — | — | — | $2.7k – $2.7k |
| 11 | Medical Mutual supermed ppo fee schedule · outpatient | $4.5k | $4.5k | — | — | — | $4.5k – $4.5k |
| 12 | Cigna all commercial plans fee schedule · outpatient | $5.6k | $5.6k | — | — | — | $5.6k – $5.6k |
Last updated: Apr 1, 2026
See Amniotic membrane wound graft, per square centimeter pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.