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 AFFINITY FRESH AMNIOTIC 2.5X2.5CM -COST PER SQ CM
Silver Spring, MD
See all hospitals reporting HCPCS Q4159 →Price type
Holy Cross Hospital-Silver Spring’s median price of $447 is 26% above the median hospital's median price ($356), higher than 61% 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: 15 payers, 26 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 cigna healthspring medicare advantage facility · percent of total billed charges · bothfrom % of charges | $403 | $403 | — | — | — | $403 – $403 |
| 2 | Aetna aetna medicare advantage facility · percent of total billed charges · bothfrom % of charges | $412 | $412 | — | — | — | $412 – $412 |
| 3 | Humana humana medicare advantage facility · percent of total billed charges · bothfrom % of charges | $412 | $412 | — | — | — | $412 – $412 |
| 4 | Kaiser kaiser medicare advantage facility · percent of total billed charges · bothfrom % of charges | $412 | $412 | — | — | — | $412 – $412 |
| 5 | Kaiser kaiser medicaid facility · percent of total billed charges · bothfrom % of charges | $414 | $414 | — | — | — | $414 – $414 |
| 6 | UnitedHealthcare united healthcare medicaid facility · percent of total billed charges · bothfrom % of charges | $414 | $414 | — | — | — | $414 – $414 |
| 7 | Carefirst care first bcbs medicaid facility · percent of total billed charges · bothfrom % of charges | $419 | $419 | — | — | — | $419 – $419 |
| 8 | UnitedHealthcare united healthcare medicare advantage facility · percent of total billed charges · bothfrom % of charges | $421 | $421 | — | — | — | $421 – $421 |
| 9 | Aetna aetna better health medicaid facility · percent of total billed charges · bothfrom % of charges | $424 | $424 | — | — | — | $424 – $424 |
| 10 | Amerihealth Caritas amerihealth caritas medicaid facility · percent of total billed charges · bothfrom % of charges | $430 | $430 | — | — | — | $430 – $430 |
| 11 | Aetna aetna facility · percent of total billed charges · bothfrom % of charges | $447 | $447 | — | — | — | $447 – $447 |
| 12 | Anthem care first bcbs facility · percent of total billed charges · bothfrom % of charges | $447 | $447 | — | — | — | $447 – $447 |
| 13 | Blue Cross Blue Shield care first bcbs facility · percent of total billed charges · bothfrom % of charges | $447 | $447 | — | — | — | $447 – $447 |
| 14 | Carefirst care first bcbs facility · percent of total billed charges · bothfrom % of charges | $447 | $447 | — | — | — | $447 – $447 |
| 15 | Cigna cigna facility · percent of total billed charges · bothfrom % of charges | $447 | $447 | — | — | — | $447 – $447 |
| 16 | Excellus care first bcbs facility · percent of total billed charges · bothfrom % of charges | $447 | $447 | — | — | — | $447 – $447 |
| 17 | Highmark care first bcbs facility · percent of total billed charges · bothfrom % of charges | $447 | $447 | — | — | — | $447 – $447 |
| 18 | Kaiser kaiser facility · percent of total billed charges · bothfrom % of charges | $447 | $447 | — | — | — | $447 – $447 |
| 19 | Premera care first bcbs facility · percent of total billed charges · bothfrom % of charges | $447 | $447 | — | — | — | $447 – $447 |
| 20 | Regence care first bcbs facility · percent of total billed charges · bothfrom % of charges | $447 | $447 | — | — | — | $447 – $447 |
| 21 | UnitedHealthcare united healthcare facility · percent of total billed charges · bothfrom % of charges | $447 | $447 | — | — | — | $447 – $447 |
| 22 | Wellmark care first bcbs facility · percent of total billed charges · bothfrom % of charges | $447 | $447 | — | — | — | $447 – $447 |
| 23 | Carefirst care first network leasing facility · percent of total billed charges · bothfrom % of charges | $451 | $451 | — | — | — | $451 – $451 |
| 24 | Humana humana facility · percent of total billed charges · bothfrom % of charges | $451 | $451 | — | — | — | $451 – $451 |
| 25 | Humana humana military facility · percent of total billed charges · bothfrom % of charges | $451 | $451 | — | — | — | $451 – $451 |
Last updated: Mar 31, 2026
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