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 2X2CM-Q4100-COST PER SHEET
Columbus, OH
See all hospitals reporting HCPCS Q4100 →Price type
Mount Carmel East’s median price of $2.9k is 60% above the median hospital's median price ($1.8k), higher than 65% of the 964 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, 33 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 | Aetna aetna neighborhood narrow network facility · percent of total billed charges · bothfrom % of charges | $66 | $66 | — | — | — | $66 – $66 |
| 2 | Aetna aetna medicare advantage facility · percent of total billed charges · bothfrom % of charges | $1.1k | $1.2k | $1.0k | 83% | — | $29 – $2.5k |
| 3 | Molina molina medicare advantage facility · percent of total billed charges · bothfrom % of charges | $1.8k | $2.0k | $1.6k | 83% | — | $47 – $4.1k |
| 4 | Anthem anthem bcbs pathway hmo facility · percent of total billed charges · bothfrom % of charges | $1.9k | $2.1k | $1.7k | 83% | — | $50 – $4.3k |
| 5 | Aetna aetna asa meritain facility · percent of total billed charges · bothfrom % of charges | $2.3k | $2.5k | $2.1k | 83% | — | $61 – $5.2k |
| 6 | Medical Mutual medical mutual medflex facility · percent of total billed charges · bothfrom % of charges | $2.4k | $2.6k | $2.2k | 83% | — | $62 – $5.3k |
| 7 | Medical Mutual medical mutual oh supermed ppo pos hmo facility · percent of total billed charges · bothfrom % of charges | $2.4k | $2.6k | $2.2k | 83% | — | $62 – $5.3k |
| 8 | Medcost cofinity facility · percent of total billed charges · bothfrom % of charges | $2.4k | $2.6k | $2.2k | 83% | — | $63 – $5.4k |
| 9 | UnitedHealthcare united healthcare ppo facility · percent of total billed charges · bothfrom % of charges | $2.6k | $2.8k | $2.4k | 83% | — | $68 – $5.9k |
| 10 | Humana choice care humana facility · percent of total billed charges · bothfrom % of charges | $2.6k | $2.9k | $2.4k | 83% | — | $69 – $5.9k |
| 11 | Humana humana one facility · percent of total billed charges · bothfrom % of charges | $2.6k | $2.9k | $2.4k | 83% | — | $69 – $5.9k |
| 12 | Anthem anthem bcbs pathway grp hmo facility · percent of total billed charges · bothfrom % of charges | $2.7k | $2.9k | $2.4k | 83% | — | $70 – $6.0k |
| 13 | First Health aetna first health facility · percent of total billed charges · bothfrom % of charges | $2.7k | $3.0k | $2.5k | 83% | — | $71 – $6.1k |
| 14 | UnitedHealthcare united healthcare exchange facility · percent of total billed charges · bothfrom % of charges | $2.9k | $3.1k | $2.6k | 83% | — | $75 – $6.4k |
| 15 | Cigna cigna facility · percent of total billed charges · bothfrom % of charges | $2.9k | $3.2k | $2.6k | 83% | — | $76 – $6.5k |
| 16 | Anthem anthem blue access ppo blue pref hmo facility · percent of total billed charges · bothfrom % of charges | $3.1k | $3.4k | $2.8k | 83% | — | $81 – $6.9k |
| 17 | Blue Cross Blue Shield anthem blue access ppo blue pref hmo facility · percent of total billed charges · bothfrom % of charges | $3.1k | $3.4k | $2.8k | 83% | — | $81 – $6.9k |
| 18 | Carefirst anthem blue access ppo blue pref hmo facility · percent of total billed charges · bothfrom % of charges | $3.1k | $3.4k | $2.8k | 83% | — | $81 – $6.9k |
| 19 | Excellus anthem blue access ppo blue pref hmo facility · percent of total billed charges · bothfrom % of charges | $3.1k | $3.4k | $2.8k | 83% | — | $81 – $6.9k |
| 20 | Highmark anthem blue access ppo blue pref hmo facility · percent of total billed charges · bothfrom % of charges | $3.1k | $3.4k | $2.8k | 83% | — | $81 – $6.9k |
| 21 | Premera anthem blue access ppo blue pref hmo facility · percent of total billed charges · bothfrom % of charges | $3.1k | $3.4k | $2.8k | 83% | — | $81 – $6.9k |
| 22 | Regence anthem blue access ppo blue pref hmo facility · percent of total billed charges · bothfrom % of charges | $3.1k | $3.4k | $2.8k | 83% | — | $81 – $6.9k |
| 23 | Wellmark anthem blue access ppo blue pref hmo facility · percent of total billed charges · bothfrom % of charges | $3.1k | $3.4k | $2.8k | 83% | — | $81 – $6.9k |
| 24 | Oscar oscar facility · percent of total billed charges · bothfrom % of charges | $3.1k | $3.4k | $2.8k | 83% | — | $81 – $6.9k |
| 25 | Caresource caresource marketplace facility · percent of total billed charges · bothfrom % of charges | $3.8k | $4.1k | $3.4k | 83% | — | $99 – $8.5k |
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.