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
ALLOGRAFT AMNIOTIC ACTIVEBARRIER 200 4X6CM-Q4100-COST PER SHEET
Muskegon, MI
See all hospitals reporting HCPCS Q4100 →Price type
Mercy Health Hackley Campus’s median price of $2.1k is 12% above the median hospital's median price ($1.8k), higher than 54% of the 968 hospitals reporting HCPCS Q4100. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 21 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.
Filter by billing methodology
Filter by billing class
| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Oscar oscar epo facility · percent of total billed charges · bothfrom % of charges | $777 | $613 | $433 | 71% | — | $20 – $1.0k |
| 2 | Molina molina medicare advantage facility · percent of total billed charges · bothfrom % of charges | $1.2k | $920 | $649 | 71% | — | $30 – $1.6k |
| 3 | Aetna aetna medicare advantage facility · percent of total billed charges · bothfrom % of charges | $1.5k | $1.2k | $823 | 71% | — | $39 – $2.0k |
| 4 | Blue Cross Blue Shield blue cross complete medicaid facility · percent of total billed charges · bothfrom % of charges | $1.5k | $1.2k | $839 | 71% | — | $39 – $2.0k |
| 5 | Molina molina medicaid facility · percent of total billed charges · bothfrom % of charges | $1.6k | $1.3k | $896 | 71% | — | $42 – $2.2k |
| 6 | Aetna aetna preferred facility · percent of total billed charges · bothfrom % of charges | $1.6k | $1.3k | $911 | 71% | — | $43 – $2.2k |
| 7 | Anthem bcbs trad / trust facility · percent of total billed charges · bothfrom % of charges | $1.9k | $1.5k | $1.1k | 71% | — | $49 – $2.5k |
| 8 | Blue Cross Blue Shield bcbs trad / trust facility · percent of total billed charges · bothfrom % of charges | $1.9k | $1.5k | $1.1k | 71% | — | $49 – $2.5k |
| 9 | Carefirst bcbs trad / trust facility · percent of total billed charges · bothfrom % of charges | $1.9k | $1.5k | $1.1k | 71% | — | $49 – $2.5k |
| 10 | Excellus bcbs trad / trust facility · percent of total billed charges · bothfrom % of charges | $1.9k | $1.5k | $1.1k | 71% | — | $49 – $2.5k |
| 11 | Highmark bcbs trad / trust facility · percent of total billed charges · bothfrom % of charges | $1.9k | $1.5k | $1.1k | 71% | — | $49 – $2.5k |
| 12 | Kaiser bcbs trad / trust facility · percent of total billed charges · bothfrom % of charges | $1.9k | $1.5k | $1.1k | 71% | — | $49 – $2.5k |
| 13 | Premera bcbs trad / trust facility · percent of total billed charges · bothfrom % of charges | $1.9k | $1.5k | $1.1k | 71% | — | $49 – $2.5k |
| 14 | Regence bcbs trad / trust facility · percent of total billed charges · bothfrom % of charges | $1.9k | $1.5k | $1.1k | 71% | — | $49 – $2.5k |
| 15 | Wellmark bcbs trad / trust facility · percent of total billed charges · bothfrom % of charges | $1.9k | $1.5k | $1.1k | 71% | — | $49 – $2.5k |
| 16 | Molina molina hmo marketplace facility · percent of total billed charges · bothfrom % of charges | $1.9k | $1.5k | $1.1k | 71% | — | $51 – $2.6k |
| 17 | Cigna priority health cigna ppo facility · percent of total billed charges · bothfrom % of charges | $2.4k | $1.9k | $1.4k | 71% | — | $64 – $3.3k |
| 18 | Caresource hap hmo facility · percent of total billed charges · bothfrom % of charges | $2.4k | $1.9k | $1.4k | 71% | — | $64 – $3.3k |
| 19 | Aetna aetna ppo facility · percent of total billed charges · bothfrom % of charges | $2.6k | $2.1k | $1.5k | 71% | — | $69 – $3.5k |
| 20 | MultiPlan multiplan facility · percent of total billed charges · bothfrom % of charges | $2.9k | $2.3k | $1.6k | 71% | — | $76 – $3.9k |
| 21 | Phcs multiplan facility · percent of total billed charges · bothfrom % of charges | $2.9k | $2.3k | $1.6k | 71% | — | $76 – $3.9k |
| 22 | Humana cofinity ppo facility · percent of total billed charges · bothfrom % of charges | $3.1k | $2.4k | $1.7k | 71% | — | $80 – $4.1k |
| 23 | Medcost cofinity ppo facility · percent of total billed charges · bothfrom % of charges | $3.1k | $2.4k | $1.7k | 71% | — | $80 – $4.1k |
| 24 | Medical Mutual cofinity ppo facility · percent of total billed charges · bothfrom % of charges | $3.1k | $2.4k | $1.7k | 71% | — | $80 – $4.1k |
| 25 | First Health first health ppo facility · percent of total billed charges · bothfrom % of charges | $3.2k | $2.5k | $1.8k | 71% | — | $83 – $4.3k |
Last updated: Mar 31, 2026
See Amniotic membrane allograft, 9 x 20 cm pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.