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
Dual layer amnio burgeon x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)
CONROE, TX
See all hospitals reporting HCPCS Q4366 →Price type
Hca Houston Healthcare Conroe’s median price of $11 is 92% below the median hospital's median price ($135), higher than 8% of the 412 hospitals reporting HCPCS Q4366. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 2 payers, 8 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 mybluehealth fee schedule · outpatient | $7 | $7 | — | — | — | $7 – $7 |
| 2 | Blue Cross Blue Shield bav fee schedule · outpatient | $8 | $8 | — | — | — | $8 – $8 |
| 3 | Blue Cross Blue Shield hmo fee schedule · outpatient | $10 | $10 | — | — | — | $10 – $10 |
| 4 | Blue Cross Blue Shield eposoa fee schedule · outpatient | $10 | $10 | — | — | — | $10 – $10 |
| 5 | Blue Cross Blue Shield ppo fee schedule · outpatient | $11 | $11 | — | — | — | $11 – $11 |
| 6 | UnitedHealthcare allpayerappendix fee schedule · outpatient | $210 | $210 | — | — | — | $210 – $210 |
| 7 | UnitedHealthcare narrownetworkindivexchange fee schedule · outpatient | $210 | $210 | — | — | — | $210 – $210 |
| 8 | UnitedHealthcare smallgroup fee schedule · outpatient | $210 | $210 | — | — | — | $210 – $210 |
Last updated: May 14, 2026
See Amniotic membrane graft, dual layer, per square centimeter pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.