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
MEMBRANE AMNIO CLARIX 4X3CM 1K -COST PER SQ CM
Elkader, IA
See all hospitals reporting HCPCS Q4155 →Price type
Central Community Hospital’s median price of $1.3k is 2591% above the median hospital's median price ($50), higher than 89% of the 1,067 hospitals reporting HCPCS Q4155. 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, 11 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.
Filter by billing methodology
Filter by billing class
| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Wellmark wellmark medicare advantage facility · percent of total billed charges · bothfrom % of charges | $1.2k | $1.2k | $1.0k | 84% | — | $194 – $2.3k |
| 2 | Aetna aetna medicare advantage facility · percent of total billed charges · bothfrom % of charges | $1.2k | $1.2k | $1.1k | 84% | — | $196 – $2.3k |
| 3 | UnitedHealthcare united healthcare medicare advantage facility · percent of total billed charges · bothfrom % of charges | $1.3k | $1.3k | $1.1k | 84% | — | $207 – $2.4k |
| 4 | Molina molina medicaid facility · percent of total billed charges · bothfrom % of charges | $1.5k | $1.5k | $1.3k | 84% | — | $238 – $2.8k |
| 5 | Aetna aetna facility · percent of total billed charges · bothfrom % of charges | $1.8k | $1.8k | $1.5k | 84% | — | $277 – $3.3k |
| 6 | First Health aetna facility · percent of total billed charges · bothfrom % of charges | $1.8k | $1.8k | $1.5k | 84% | — | $277 – $3.3k |
| 7 | Medical Mutual aetna facility · percent of total billed charges · bothfrom % of charges | $1.8k | $1.8k | $1.5k | 84% | — | $277 – $3.3k |
| 8 | Ambetter ambetter marketplace facility · percent of total billed charges · bothfrom % of charges | $2.1k | $2.1k | $1.8k | 84% | — | $329 – $3.9k |
| 9 | UnitedHealthcare united healthcare facility · percent of total billed charges · bothfrom % of charges | $2.1k | $2.1k | $1.8k | 84% | — | $329 – $3.9k |
| 10 | Cigna midlands choice facility · percent of total billed charges · bothfrom % of charges | $2.4k | $2.4k | $2.0k | 84% | — | $369 – $4.3k |
| 11 | Medica midlands choice facility · percent of total billed charges · bothfrom % of charges | $2.4k | $2.4k | $2.0k | 84% | — | $369 – $4.3k |
Last updated: Mar 31, 2026
See Amniotic tissue fluid graft, per 1 mg pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.