Skin graft substitute material at AMH Cath Labs LLC

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

TISSUE DERMASPAN 5X10/50SQCM

Arlington, TX

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Pricing by billing methodology

Price type

How this price compares nationally

AMH Cath Labs LLC’s median price of $139 is about the same as the median hospital's median price ($139), higher than 50% of the 1,135 hospitals reporting HCPCS Q4126. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS Q4126 at AMH Cath Labs LLC

Negotiated rates from the hospital’s own file: 9 payers, 33 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.

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1	Blue Cross Blue Shield managed medicaid percent of total billed charges · outpatientfrom % of charges	$25	$28	$10	36%	—	$15 – $44
2	UnitedHealthcare managed medicaid percent of total billed charges · outpatientfrom % of charges	$25	$28	$10	36%	—	$15 – $44
3	WellCare managed medicaid percent of total billed charges · outpatientfrom % of charges	$26	$29	$11	36%	—	$16 – $46
4	Molina managed medicaid percent of total billed charges · outpatientfrom % of charges	$27	$30	$11	36%	—	$16 – $47
5	Aetna managed medicaid percent of total billed charges · outpatientfrom % of charges	$27	$31	$11	36%	—	$17 – $48
6	Blue Cross Blue Shield exchange percent of total billed charges · outpatientfrom % of charges	$81	$91	$33	36%	—	$49 – $143
7	Aetna whole health percent of total billed charges · inpatientfrom % of charges	$96	$109	$39	36%	—	$59 – $170
8	Blue Cross Blue Shield medicare advantage case rate · outpatient	$125	$125	—	—	—	$125 – $125
9	Aetna whole health percent of total billed charges · outpatientfrom % of charges	$114	$129	$46	36%	—	$70 – $202
10	Humana medicare advantage case rate · outpatient	$130	$130	—	—	—	$130 – $130
11	Humana medicare advantage ppo case rate · outpatient	$130	$130	—	—	—	$130 – $130
12	Molina medicare advantage case rate · outpatient	$131	$131	—	—	—	$131 – $131
13	WellCare medicare advantage hmo case rate · outpatient	$131	$131	—	—	—	$131 – $131
14	WellCare medicare advantage mmp case rate · outpatient	$138	$138	—	—	—	$138 – $138
15	UnitedHealthcare medicare advantage ppo case rate · outpatient	$139	$139	—	—	—	$139 – $139
16	UnitedHealthcare medicare advantage hmo case rate · outpatient	$142	$142	—	—	—	$142 – $142
17	Aetna commercial percent of total billed charges · inpatientfrom % of charges	$128	$145	$52	36%	—	$79 – $227
18	Blue Cross Blue Shield hmo percent of total billed charges · outpatientfrom % of charges	$128	$146	$52	36%	—	$79 – $227
19	Blue Cross Blue Shield ppo percent of total billed charges · outpatientfrom % of charges	$143	$162	$58	36%	—	$88 – $253
20	UnitedHealthcare all payer percent of total billed charges · outpatientfrom % of charges	$144	$163	$58	36%	—	$88 – $254
21	Aetna commercial percent of total billed charges · outpatientfrom % of charges	$152	$173	$62	36%	—	$93 – $269
22	UnitedHealthcare ppo percent of total billed charges · outpatientfrom % of charges	$152	$173	$62	36%	—	$93 – $270
23	Cigna oap/hmo percent of total billed charges · outpatientfrom % of charges	$153	$174	$62	36%	—	$94 – $272
24	Phcs ppo percent of total billed charges · outpatientfrom % of charges	$193	$219	$78	36%	—	$118 – $342
25	Cigna ppo percent of total billed charges · outpatientfrom % of charges	$193	$220	$78	36%	—	$119 – $343

Page 1 of 2 · 33 rates

Last updated: Apr 21, 2026

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