Grafix Prime wound care tissue 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

TISSUE STRAVIX 3X6/18 SQCM

Arlington, TX

See all hospitals reporting HCPCS Q4133 →

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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 $323 is 24% above the median hospital's median price ($260), higher than 62% of the 1,822 hospitals reporting HCPCS Q4133. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS Q4133 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	$64	$79	$38	48%	—	$38 – $168
2	UnitedHealthcare managed medicaid percent of total billed charges · outpatientfrom % of charges	$64	$79	$38	48%	—	$38 – $168
3	WellCare managed medicaid percent of total billed charges · outpatientfrom % of charges	$67	$83	$40	48%	—	$40 – $176
4	Molina managed medicaid percent of total billed charges · outpatientfrom % of charges	$69	$85	$41	48%	—	$41 – $181
5	Aetna managed medicaid percent of total billed charges · outpatientfrom % of charges	$70	$87	$42	48%	—	$42 – $185
6	Blue Cross Blue Shield medicare advantage case rate · outpatient	$125	$125	—	—	—	$125 – $125
7	Humana medicare advantage case rate · outpatient	$130	$130	—	—	—	$130 – $130
8	Humana medicare advantage ppo case rate · outpatient	$130	$130	—	—	—	$130 – $130
9	Molina medicare advantage case rate · outpatient	$131	$131	—	—	—	$131 – $131
10	WellCare medicare advantage hmo case rate · outpatient	$131	$131	—	—	—	$131 – $131
11	WellCare medicare advantage mmp case rate · outpatient	$138	$138	—	—	—	$138 – $138
12	UnitedHealthcare medicare advantage ppo case rate · outpatient	$139	$139	—	—	—	$139 – $139
13	UnitedHealthcare medicare advantage hmo case rate · outpatient	$142	$142	—	—	—	$142 – $142
14	Blue Cross Blue Shield exchange percent of total billed charges · outpatientfrom % of charges	$207	$257	$123	48%	—	$124 – $547
15	Aetna whole health percent of total billed charges · inpatientfrom % of charges	$247	$306	$147	48%	—	$148 – $653
16	Aetna whole health percent of total billed charges · outpatientfrom % of charges	$293	$363	$175	48%	—	$176 – $775
17	Aetna commercial percent of total billed charges · inpatientfrom % of charges	$329	$408	$196	48%	—	$198 – $870
18	Blue Cross Blue Shield hmo percent of total billed charges · outpatientfrom % of charges	$330	$409	$196	48%	—	$198 – $872
19	Blue Cross Blue Shield ppo percent of total billed charges · outpatientfrom % of charges	$367	$455	$219	48%	—	$221 – $970
20	UnitedHealthcare all payer percent of total billed charges · outpatientfrom % of charges	$369	$458	$220	48%	—	$222 – $976
21	Aetna commercial percent of total billed charges · outpatientfrom % of charges	$391	$485	$233	48%	—	$235 – $1.0k
22	UnitedHealthcare ppo percent of total billed charges · outpatientfrom % of charges	$391	$485	$233	48%	—	$235 – $1.0k
23	Cigna oap/hmo percent of total billed charges · outpatientfrom % of charges	$395	$489	$235	48%	—	$237 – $1.0k
24	Phcs ppo percent of total billed charges · outpatientfrom % of charges	$496	$615	$296	48%	—	$298 – $1.3k
25	Cigna ppo percent of total billed charges · outpatientfrom % of charges	$498	$617	$296	48%	—	$299 – $1.3k

Page 1 of 2 · 33 rates

Last updated: Apr 21, 2026

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