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.
Original text from hospital filings
MATRIX AFFINITY 1.5X1.5/2SQCM
Arlington, TX
See all hospitals reporting HCPCS Q4159 →Price type
AMH Cath Labs LLC’s median price of $638 is 79% above the median hospital's median price ($356), higher than 74% of the 1,407 hospitals reporting HCPCS Q4159. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
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 medicare advantage case rate · outpatient | $125 | $125 | — | — | — | $125 – $125 |
| 2 | Humana medicare advantage case rate · outpatient | $130 | $130 | — | — | — | $130 – $130 |
| 3 | Humana medicare advantage ppo case rate · outpatient | $130 | $130 | — | — | — | $130 – $130 |
| 4 | Molina medicare advantage case rate · outpatient | $131 | $131 | — | — | — | $131 – $131 |
| 5 | WellCare medicare advantage hmo case rate · outpatient | $131 | $131 | — | — | — | $131 – $131 |
| 6 | WellCare medicare advantage mmp case rate · outpatient | $138 | $138 | — | — | — | $138 – $138 |
| 7 | UnitedHealthcare medicare advantage ppo case rate · outpatient | $139 | $139 | — | — | — | $139 – $139 |
| 8 | UnitedHealthcare medicare advantage hmo case rate · outpatient | $142 | $142 | — | — | — | $142 – $142 |
| 9 | Blue Cross Blue Shield managed medicaid percent of total billed charges · outpatientfrom % of charges | $170 | $170 | $76 | 45% | — | $94 – $246 |
| 10 | UnitedHealthcare managed medicaid percent of total billed charges · outpatientfrom % of charges | $170 | $170 | $76 | 45% | — | $94 – $246 |
| 11 | WellCare managed medicaid percent of total billed charges · outpatientfrom % of charges | $179 | $179 | $80 | 45% | — | $99 – $259 |
| 12 | Molina managed medicaid percent of total billed charges · outpatientfrom % of charges | $184 | $184 | $82 | 45% | — | $101 – $266 |
| 13 | Aetna managed medicaid percent of total billed charges · outpatientfrom % of charges | $187 | $187 | $84 | 45% | — | $103 – $271 |
| 14 | Blue Cross Blue Shield exchange percent of total billed charges · outpatientfrom % of charges | $554 | $554 | $248 | 45% | — | $306 – $803 |
| 15 | Aetna whole health percent of total billed charges · inpatientfrom % of charges | $661 | $661 | $296 | 45% | — | $365 – $957 |
| 16 | Aetna whole health percent of total billed charges · outpatientfrom % of charges | $785 | $785 | $352 | 45% | — | $433 – $1.1k |
| 17 | Aetna commercial percent of total billed charges · inpatientfrom % of charges | $881 | $881 | $395 | 45% | — | $486 – $1.3k |
| 18 | Blue Cross Blue Shield hmo percent of total billed charges · outpatientfrom % of charges | $883 | $883 | $396 | 45% | — | $487 – $1.3k |
| 19 | Blue Cross Blue Shield ppo percent of total billed charges · outpatientfrom % of charges | $982 | $982 | $440 | 45% | — | $542 – $1.4k |
| 20 | UnitedHealthcare all payer percent of total billed charges · outpatientfrom % of charges | $988 | $988 | $443 | 45% | — | $545 – $1.4k |
| 21 | Aetna commercial percent of total billed charges · outpatientfrom % of charges | $1.0k | $1.0k | $469 | 45% | — | $577 – $1.5k |
| 22 | UnitedHealthcare ppo percent of total billed charges · outpatientfrom % of charges | $1.0k | $1.0k | $469 | 45% | — | $578 – $1.5k |
| 23 | Cigna oap/hmo percent of total billed charges · outpatientfrom % of charges | $1.1k | $1.1k | $474 | 45% | — | $583 – $1.5k |
| 24 | Phcs ppo percent of total billed charges · outpatientfrom % of charges | $1.3k | $1.3k | $595 | 45% | — | $733 – $1.9k |
| 25 | Cigna ppo percent of total billed charges · outpatientfrom % of charges | $1.3k | $1.3k | $597 | 45% | — | $735 – $1.9k |
Last updated: Apr 21, 2026
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