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/BIO EXCEL SQCM
Longview, TX
See all hospitals reporting HCPCS Q4137 →Price type
Longview Medical Center LP’s median price of $209 is 31% above the median hospital's median price ($159), higher than 64% of the 1,253 hospitals reporting HCPCS Q4137. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 10 payers, 37 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 | Medicaid node tx medicaid facility · fee schedule · outpatient | $90 | $90 | — | — | — | $90 – $90 |
| 2 | UnitedHealthcare node uhc chip medicaid tx facility · fee schedule · outpatient | $90 | $90 | — | — | — | $90 – $90 |
| 3 | UnitedHealthcare node uhc star medicaid tx facility · fee schedule · outpatient | $90 | $90 | — | — | — | $90 – $90 |
| 4 | Molina node molina chip medicaid tx facility · per diem · outpatient | $94 | $94 | — | — | — | $94 – $94 |
| 5 | Superior Healthplan node superior star kids medicaid tx facility · fee schedule · outpatient | $94 | $94 | — | — | — | $94 – $94 |
| 6 | Humana node humana mcr adv facility · fee schedule · outpatient | $123 | $123 | — | — | — | $123 – $123 |
| 7 | Humana node wellmed humana mcr adv facility · fee schedule · outpatient | $123 | $123 | — | — | — | $123 – $123 |
| 8 | UnitedHealthcare node uhc mcr adv facility · fee schedule · outpatient | $123 | $123 | — | — | — | $123 – $123 |
| 9 | UnitedHealthcare node wellmed uhc mcr adv facility · fee schedule · outpatient | $123 | $123 | — | — | — | $123 – $123 |
| 10 | Aetna node aetna mcr adv facility · other · outpatient | $125 | $125 | — | — | — | $125 – $125 |
| 11 | Blue Cross Blue Shield node bcbs tx mcr hmo facility · fee schedule · outpatient | $125 | $125 | — | — | — | $125 – $125 |
| 12 | Blue Cross Blue Shield node bcbs tx mcr ppo facility · fee schedule · outpatient | $125 | $125 | — | — | — | $125 – $125 |
| 13 | Tricare node tricare facility · fee schedule · outpatient | $127 | $127 | — | — | — | $127 – $127 |
| 14 | UnitedHealthcare node uhc star plus medicaid tx facility · fee schedule · outpatient | $189 | $189 | — | — | — | $189 – $189 |
| 15 | Molina node molina star plus medicaid tx facility · per diem · outpatient | $198 | $198 | — | — | — | $198 – $198 |
| 16 | UnitedHealthcare node uhc star kids medicaid tx facility · other · outpatient | $209 | $209 | — | — | — | $209 – $209 |
| 17 | UnitedHealthcare uhc exchange facility · per diem · outpatient | $238 | $238 | — | — | — | $238 – $238 |
| 18 | Superior Healthplan node superior star medicaid tx facility · fee schedule · outpatient | $332 | $332 | — | — | — | $332 – $332 |
| 19 | UnitedHealthcare uhc apa facility · percent of total billed charges · inpatientfrom % of charges | $607 | $607 | — | — | — | $607 – $607 |
| 20 | UnitedHealthcare uhc apa facility · percent of total billed charges · outpatientfrom % of charges | $607 | $607 | — | — | — | $607 – $607 |
| 21 | UnitedHealthcare uhc health select facility · percent of total billed charges · outpatientfrom % of charges | $698 | $698 | — | — | — | $698 – $698 |
| 22 | Aetna aetna nbd facility · percent of total billed charges · inpatientfrom % of charges | $798 | $798 | — | — | — | $798 – $798 |
| 23 | Aetna aetna nbd facility · percent of total billed charges · outpatientfrom % of charges | $798 | $798 | — | — | — | $798 – $798 |
| 24 | Cigna cigna all facility · other · outpatient | $893 | $893 | — | — | — | $893 – $893 |
| 25 | Aetna aetna all facility · percent of total billed charges · outpatientfrom % of charges | $945 | $945 | — | — | — | $945 – $945 |
Last updated: Apr 1, 2026
See Amniotic membrane 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.