Amniotic membrane graft, per square centimeter

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Amniocore per sq cm

Payers reporting HCPCS Q4227

Payer pricing summary

Low

Average

$797

Median

$440

High

$7.1k

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +12 other terms	431	$296	$928	$1.2k	125%	—	$48 – $7.5k
2	Cigna fee schedule · outpatient · +12 other terms	269	$1.4k	$2.5k	$2.6k	104%	—	$102 – $10.0k
3	Aetna fee schedule · outpatient · +12 other terms	242	$147	$556	$1.1k	205%	—	$69 – $11.7k
4	Blue Cross Blue Shield fee schedule · outpatient · +7 other terms	188	$125	$240	$455	190%	—	$1 – $2.1k
5	Humana fee schedule · outpatient · +10 other terms	184	$505	$572	$498	87%	—	$48 – $1.3k
6	Molina fee schedule · outpatient · +7 other terms	61	$193	$286	$423	148%	—	$51 – $3.4k
7	Anthem facility · fee schedule · outpatient · +7 other terms	55	$177	$706	$937	133%	—	$48 – $4.2k
8	Caresource fee schedule · outpatient · +3 other terms	49	$191	$449	$575	128%	—	$48 – $2.0k
9	WellCare fee schedule · outpatient · +6 other terms	49	$140	$258	$331	128%	—	$115 – $1.2k
10	Ambetter fee schedule · outpatient · +4 other terms	42	$234	$579	$803	139%	—	$162 – $2.8k
11	Kaiser fee schedule · outpatient · +4 other terms	42	$207	$304	$328	108%	—	$125 – $2.4k
12	Devoted fee schedule · outpatient · +3 other terms	35	$125	$125	$8	6%	—	$116 – $139
13	Optum fee schedule · outpatient · +4 other terms	32	$125	$173	$91	53%	—	$113 – $459
14	Bcbs Tx fee schedule · outpatient	30	$8	$8	$3	31%	—	$6 – $30
15	Regence professional · fee schedule · outpatient · +4 other terms	21	$291	$319	$160	50%	—	$153 – $1.0k
16	Healthpartners fee schedule · outpatient · +1 other terms	19	$1.2k	$1.2k	$182	15%	—	$131 – $1.3k
17	Oscar facility · fee schedule · outpatient · +2 other terms	19	$234	$566	$571	101%	—	$175 – $1.4k
18	Medical Mutual facility · fee schedule · outpatient · +3 other terms	18	$1.9k	$2.0k	$1.6k	80%	—	$64 – $5.0k
19	Medicare fee schedule · outpatient · +1 other terms	18	$125	$125	—	—	—	$125 – $125
20	Highmark fee schedule · outpatient · +4 other terms	16	$1.5k	$1.4k	$364	26%	—	$127 – $3.4k
21	Wellmark fee schedule · both · +3 other terms	14	$450	$467	$114	24%	—	$378 – $1.2k
22	Aetna Better Health fee schedule · outpatient · +4 other terms	11	$969	$660	$409	62%	—	$119 – $969
23	Bcbs Nj fee schedule · outpatient	11	$602	$614	$316	51%	—	$448 – $1.2k
24	Tricare fee schedule · outpatient · +2 other terms	11	$113	$118	$10	8%	—	$113 – $148
25	Medica fee schedule · outpatient · +4 other terms	10	$195	$197	$49	25%	—	$118 – $252

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