Dermapure skin graft material, 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 DERMAPURE 4X6/24 SQCM

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 $174 is 37% above the median hospital's median price ($127), higher than 77% of the 1,112 hospitals reporting HCPCS Q4152. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS Q4152 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	$45	$46	$23	51%	—	$12 – $90
2	UnitedHealthcare managed medicaid percent of total billed charges · outpatientfrom % of charges	$45	$46	$23	51%	—	$12 – $90
3	WellCare managed medicaid percent of total billed charges · outpatientfrom % of charges	$48	$48	$25	51%	—	$13 – $95
4	Molina managed medicaid percent of total billed charges · outpatientfrom % of charges	$49	$49	$25	51%	—	$13 – $98
5	Aetna managed medicaid percent of total billed charges · outpatientfrom % of charges	$50	$50	$26	51%	—	$13 – $99
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	$148	$149	$76	51%	—	$39 – $294
15	Aetna whole health percent of total billed charges · inpatientfrom % of charges	$176	$178	$91	51%	—	$47 – $351
16	Aetna whole health percent of total billed charges · outpatientfrom % of charges	$209	$211	$108	51%	—	$56 – $417
17	Aetna commercial percent of total billed charges · inpatientfrom % of charges	$235	$237	$121	51%	—	$62 – $468
18	Blue Cross Blue Shield hmo percent of total billed charges · outpatientfrom % of charges	$235	$237	$121	51%	—	$63 – $469
19	Blue Cross Blue Shield ppo percent of total billed charges · outpatientfrom % of charges	$262	$264	$135	51%	—	$70 – $522
20	UnitedHealthcare all payer percent of total billed charges · outpatientfrom % of charges	$264	$266	$136	51%	—	$70 – $525
21	Aetna commercial percent of total billed charges · outpatientfrom % of charges	$279	$281	$144	51%	—	$74 – $556
22	UnitedHealthcare ppo percent of total billed charges · outpatientfrom % of charges	$279	$282	$144	51%	—	$74 – $556
23	Cigna oap/hmo percent of total billed charges · outpatientfrom % of charges	$282	$284	$145	51%	—	$75 – $561
24	Phcs ppo percent of total billed charges · outpatientfrom % of charges	$354	$357	$182	51%	—	$94 – $705
25	Cigna ppo percent of total billed charges · outpatientfrom % of charges	$355	$358	$183	51%	—	$94 – $707

Page 1 of 2 · 33 rates

Last updated: Apr 21, 2026

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