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
Houston, TX
See all hospitals reporting HCPCS Q4239 →Price type
Methodist Willowbrook Hospital’s median price of $171 is 32% below the median hospital's median price ($252), higher than 34% 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: 6 payers, 11 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 medicare managed care - hmo fee schedule · outpatient | $125 | $125 | — | — | — | $125 – $125 |
| 2 | Aetna medicare managed care - hmo/ppo fee schedule · outpatient | $127 | $127 | — | — | — | $127 – $127 |
| 3 | UnitedHealthcare medicare managed care - hmo fee schedule · outpatient | $128 | $128 | — | — | — | $128 – $128 |
| 4 | Cigna texas healthspring medicare managed care - hmo/ppo fee schedule · outpatient | $129 | $129 | — | — | — | $129 – $129 |
| 5 | Molina advantage medicare managed care plan fee schedule · outpatient | $131 | $131 | — | — | — | $131 – $131 |
| 6 | Optum transplant medicare managed care plan fee schedule · outpatient | $244 | $244 | — | — | — | $244 – $244 |
| 7 | Molina exchange fee schedule · outpatient | $250 | $250 | — | — | — | $250 – $250 |
| 8 | Cigna local plus/surefit hmo/ppo fee schedule · outpatient | $4.8k | $4.8k | — | — | — | $4.8k – $4.8k |
| 9 | Cigna network c-24 hmo/ppo fee schedule · outpatient | $4.8k | $4.8k | — | — | — | $4.8k – $4.8k |
| 10 | Cigna pcp optional/pcp required benefit plans hmo fee schedule · outpatient | $5.1k | $5.1k | — | — | — | $5.1k – $5.1k |
| 11 | UnitedHealthcare all commercial plans fee schedule · outpatient | $13.9k | $13.9k | — | — | — | $13.9k – $13.9k |
Last updated: Apr 1, 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.