Human dermal matrix graft 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

ALLOPATCH PLIABLE MESH 4X4/16SQCM

Arlington, TX

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Pricing by billing methodology

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How this price compares nationally

AMH Cath Labs LLC’s median price of $88 is 34% below the median hospital's median price ($133), higher than 32% of the 1,532 hospitals reporting HCPCS Q4128. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS Q4128 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	$11	$13	$8	60%	—	$6 – $41
2	UnitedHealthcare managed medicaid percent of total billed charges · outpatientfrom % of charges	$11	$13	$8	60%	—	$6 – $41
3	WellCare managed medicaid percent of total billed charges · outpatientfrom % of charges	$12	$14	$8	60%	—	$6 – $43
4	Molina managed medicaid percent of total billed charges · outpatientfrom % of charges	$12	$15	$9	60%	—	$7 – $44
5	Aetna managed medicaid percent of total billed charges · outpatientfrom % of charges	$12	$15	$9	60%	—	$7 – $45
6	Blue Cross Blue Shield exchange percent of total billed charges · outpatientfrom % of charges	$37	$44	$26	60%	—	$20 – $134
7	Aetna whole health percent of total billed charges · inpatientfrom % of charges	$44	$52	$31	60%	—	$24 – $160
8	Aetna whole health percent of total billed charges · outpatientfrom % of charges	$52	$62	$37	60%	—	$28 – $189
9	Aetna commercial percent of total billed charges · inpatientfrom % of charges	$58	$70	$42	60%	—	$32 – $213
10	Blue Cross Blue Shield hmo percent of total billed charges · outpatientfrom % of charges	$58	$70	$42	60%	—	$32 – $213
11	Blue Cross Blue Shield ppo percent of total billed charges · outpatientfrom % of charges	$65	$78	$47	60%	—	$35 – $237
12	UnitedHealthcare all payer percent of total billed charges · outpatientfrom % of charges	$65	$78	$47	60%	—	$35 – $239
13	Aetna commercial percent of total billed charges · outpatientfrom % of charges	$69	$83	$50	60%	—	$37 – $253
14	UnitedHealthcare ppo percent of total billed charges · outpatientfrom % of charges	$69	$83	$50	60%	—	$38 – $253
15	Cigna oap/hmo percent of total billed charges · outpatientfrom % of charges	$70	$84	$50	60%	—	$38 – $255
16	Phcs ppo percent of total billed charges · outpatientfrom % of charges	$88	$105	$63	60%	—	$48 – $321
17	Cigna ppo percent of total billed charges · outpatientfrom % of charges	$88	$105	$63	60%	—	$48 – $321
18	Aetna asa percent of total billed charges · outpatientfrom % of charges	$88	$106	$64	60%	—	$48 – $323
19	Aetna coventry percent of total billed charges · outpatientfrom % of charges	$88	$106	$64	60%	—	$48 – $323
20	Phcs ppo percent of total billed charges · inpatientfrom % of charges	$94	$113	$68	60%	—	$51 – $344
21	Blue Cross Blue Shield traditional percent of total billed charges · outpatientfrom % of charges	$104	$125	$75	60%	—	$56 – $381
22	Blue Cross Blue Shield medicare advantage case rate · outpatient	$125	$125	—	—	—	$125 – $125
23	Humana medicare advantage case rate · outpatient	$130	$130	—	—	—	$130 – $130
24	Humana medicare advantage ppo case rate · outpatient	$130	$130	—	—	—	$130 – $130
25	Molina medicare advantage case rate · outpatient	$131	$131	—	—	—	$131 – $131

Page 1 of 2 · 33 rates

Last updated: Apr 21, 2026

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