Biovance amniotic tissue 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-sonnet-5-5
Provider: anthropic
API: message_batches
Reasoning effort: model default
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

ALLOGRAFT BIOVANCE 6X6/36SQCM

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 $66 is 62% below the median hospital's median price ($174), higher than 2% of the 1,084 hospitals reporting HCPCS Q4154. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS Q4154 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	$8	$14	$13	96%	—	$6 – $43
2	UnitedHealthcare managed medicaid percent of total billed charges · outpatientfrom % of charges	$8	$14	$13	96%	—	$6 – $43
3	WellCare managed medicaid percent of total billed charges · outpatientfrom % of charges	$9	$14	$14	96%	—	$7 – $45
4	Molina managed medicaid percent of total billed charges · outpatientfrom % of charges	$9	$15	$14	96%	—	$7 – $46
5	Aetna managed medicaid percent of total billed charges · outpatientfrom % of charges	$9	$15	$14	96%	—	$7 – $47
6	Blue Cross Blue Shield exchange percent of total billed charges · outpatientfrom % of charges	$27	$44	$42	96%	—	$21 – $139
7	Aetna whole health percent of total billed charges · inpatientfrom % of charges	$33	$53	$50	96%	—	$25 – $165
8	Aetna whole health percent of total billed charges · outpatientfrom % of charges	$39	$62	$60	96%	—	$30 – $196
9	Aetna commercial percent of total billed charges · inpatientfrom % of charges	$44	$70	$67	96%	—	$33 – $220
10	Blue Cross Blue Shield hmo percent of total billed charges · outpatientfrom % of charges	$44	$70	$67	96%	—	$33 – $221
11	Blue Cross Blue Shield ppo percent of total billed charges · outpatientfrom % of charges	$49	$78	$75	96%	—	$37 – $246
12	UnitedHealthcare all payer percent of total billed charges · outpatientfrom % of charges	$49	$79	$75	96%	—	$37 – $247
13	Aetna commercial percent of total billed charges · outpatientfrom % of charges	$52	$83	$80	96%	—	$40 – $262
14	UnitedHealthcare ppo percent of total billed charges · outpatientfrom % of charges	$52	$83	$80	96%	—	$40 – $262
15	Cigna oap/hmo percent of total billed charges · outpatientfrom % of charges	$52	$84	$81	96%	—	$40 – $264
16	Phcs ppo percent of total billed charges · outpatientfrom % of charges	$66	$106	$101	96%	—	$50 – $332
17	Cigna ppo percent of total billed charges · outpatientfrom % of charges	$66	$106	$102	96%	—	$50 – $333
18	Aetna asa percent of total billed charges · outpatientfrom % of charges	$66	$107	$102	96%	—	$51 – $335
19	Aetna coventry percent of total billed charges · outpatientfrom % of charges	$66	$107	$102	96%	—	$51 – $335
20	Phcs ppo percent of total billed charges · inpatientfrom % of charges	$71	$113	$109	96%	—	$54 – $356
21	Blue Cross Blue Shield medicare advantage case rate · outpatient	$125	$125	—	—	—	$125 – $125
22	Blue Cross Blue Shield traditional percent of total billed charges · outpatientfrom % of charges	$78	$126	$120	96%	—	$60 – $394
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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