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
Amnio-maxx or lite per sq cm
Maple Grove, MN
See all hospitals reporting HCPCS Q4239 →Price type
Fairview Maple Grove Surgery Center’s median price of $1.2k is 378% above the median hospital's median price ($252), higher than 61% of the 927 hospitals reporting HCPCS Q4239. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 4 payers, 13 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 | Cigna commercial fee schedule · both | $82 | $82 | $7 | 9% | — | $75 – $89 |
| 2 | Medica bold fee schedule · both | $129 | $129 | — | — | — | $129 – $129 |
| 3 | Medica choice without / elect fee schedule · both | $144 | $144 | — | — | — | $144 – $144 |
| 4 | Medica city of st paul / essential uplan fee schedule · both | $144 | $144 | — | — | — | $144 – $144 |
| 5 | Medica choice with fee schedule · both | $149 | $149 | — | — | — | $149 – $149 |
| 6 | Blue Cross Blue Shield medicaid fee schedule · outpatient | $211 | $211 | — | — | — | $211 – $211 |
| 7 | Blue Cross Blue Shield federal fee schedule · outpatient | $348 | $348 | — | — | — | $348 – $348 |
| 8 | Blue Cross Blue Shield commercial fee schedule · outpatient | $354 | $354 | — | — | — | $354 – $354 |
| 9 | Medica ma non-snp fee schedule · both | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 10 | Medica ma snp fee schedule · both | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 11 | Medica prime solution fee schedule · both | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 12 | Medica vantage fee schedule · both | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 13 | UnitedHealthcare commercial fee schedule · both | $4.5k | $4.5k | — | — | — | $4.5k – $4.5k |
Last updated: May 18, 2026
See Amniotic membrane wound graft, per square centimeter pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.