Amniotic membrane graft, per square centimeter 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

ALLOGRAFT AMNIOEXCEL+ 3X3/9SQCM

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 $298 is 87% above the median hospital's median price ($159), higher than 78% of the 1,253 hospitals reporting HCPCS Q4137. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS Q4137 at AMH Cath Labs LLC

Negotiated rates from the hospital’s own file: 9 payers, 31 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	$60	$60	$16	26%	—	$44 – $75
2	UnitedHealthcare managed medicaid percent of total billed charges · outpatientfrom % of charges	$60	$60	$16	26%	—	$44 – $75
3	WellCare managed medicaid percent of total billed charges · outpatientfrom % of charges	$63	$63	$17	26%	—	$46 – $79
4	Molina managed medicaid percent of total billed charges · outpatientfrom % of charges	$64	$64	$17	26%	—	$47 – $81
5	Aetna managed medicaid percent of total billed charges · outpatientfrom % of charges	$65	$65	$17	26%	—	$48 – $83
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	$207	$55	26%	—	$153 – $262
15	Aetna whole health percent of total billed charges · outpatientfrom % of charges	$275	$275	$73	26%	—	$202 – $347
16	Blue Cross Blue Shield hmo percent of total billed charges · outpatientfrom % of charges	$334	$334	$88	26%	—	$246 – $423
17	Aetna commercial percent of total billed charges · outpatientfrom % of charges	$366	$366	$97	26%	—	$269 – $463
18	Cigna oap/hmo percent of total billed charges · outpatientfrom % of charges	$370	$370	$98	26%	—	$272 – $467
19	Blue Cross Blue Shield ppo percent of total billed charges · outpatientfrom % of charges	$372	$372	$98	26%	—	$274 – $470
20	Blue Cross Blue Shield traditional percent of total billed charges · outpatientfrom % of charges	$372	$372	$98	26%	—	$274 – $470
21	UnitedHealthcare all payer percent of total billed charges · outpatientfrom % of charges	$422	$422	$111	26%	—	$310 – $533
22	UnitedHealthcare ppo percent of total billed charges · outpatientfrom % of charges	$446	$446	$118	26%	—	$328 – $564
23	Phcs ppo percent of total billed charges · outpatientfrom % of charges	$465	$465	$123	26%	—	$342 – $588
24	Cigna ppo percent of total billed charges · outpatientfrom % of charges	$466	$466	$123	26%	—	$343 – $589
25	Aetna asa percent of total billed charges · outpatientfrom % of charges	$469	$469	$124	26%	—	$345 – $593

Page 1 of 2 · 31 rates

Last updated: Apr 21, 2026

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