Amniotic membrane allograft, 9 x 20 cm at Northside Hospital, Inc.

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

SKIN SUBSTITUTE NOS LVL 1

Duluth, GA

See all hospitals reporting HCPCS Q4100 →

SharePost on X LinkedIn

Pricing by billing methodology

Price type

How this price compares nationally

Northside Hospital, Inc.’s median price of $66 is 96% below the median hospital's median price ($1.8k), higher than 13% of the 962 hospitals reporting HCPCS Q4100. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS Q4100 at Northside Hospital, Inc.

Negotiated rates from the hospital’s own file: 9 payers, 57 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	Caresource caresource other · outpatient	$13	$14	$4	30%	—	$9 – $19
2	Cigna cigna healthsprings medicare advantage other · outpatient	$18	$18	$5	30%	—	$12 – $25
3	Blue Cross Blue Shield bcbs_pathway other · outpatient	$19	$19	$6	30%	—	$12 – $26
4	Blue Cross Blue Shield bcbs_pathway-l other · outpatient	$19	$19	$6	30%	—	$12 – $26
5	Blue Cross Blue Shield blue hpn other · outpatient	$29	$30	$9	30%	—	$19 – $41
6	Blue Cross Blue Shield blue hpn-l other · outpatient	$29	$30	$9	30%	—	$19 – $41
7	Blue Cross Blue Shield bcbs_hmo other · outpatient	$37	$38	$11	30%	—	$25 – $53
8	Blue Cross Blue Shield bcbs_hmo-l other · outpatient	$37	$38	$11	30%	—	$25 – $53
9	Caresource caresource marketplace percent of total billed charges · inpatientfrom % of charges	$38	$39	$12	30%	—	$25 – $54
10	Caresource caresource marketplace percent of total billed charges · outpatientfrom % of charges	$38	$39	$12	30%	—	$25 – $54
11	Blue Cross Blue Shield bcbs_ppo other · outpatient	$44	$45	$13	30%	—	$30 – $62
12	Blue Cross Blue Shield bcbs_ppo-l other · outpatient	$44	$45	$13	30%	—	$30 – $62
13	Aetna aetna whole health percent of total billed charges · outpatientfrom % of charges	$51	$52	$16	30%	—	$34 – $72
14	Aetna aetna whole health-g percent of total billed charges · outpatientfrom % of charges	$51	$52	$16	30%	—	$34 – $72
15	Oscar oscar percent of total billed charges · inpatientfrom % of charges	$51	$52	$16	30%	—	$34 – $72
16	Oscar oscar percent of total billed charges · outpatientfrom % of charges	$51	$52	$16	30%	—	$34 – $72
17	Cigna cigna other · outpatient	$64	$66	$20	30%	—	$43 – $91
18	Cigna cigna-g other · outpatient	$64	$66	$20	30%	—	$43 – $91
19	Cigna cigna-h other · outpatient	$64	$66	$20	30%	—	$43 – $91
20	Cigna cigna-l other · outpatient	$64	$66	$20	30%	—	$43 – $91
21	Kaiser kaiser_hmo percent of total billed charges · outpatientfrom % of charges	$66	$68	$20	30%	—	$44 – $94
22	Kaiser kaiser_hmo-aga percent of total billed charges · outpatientfrom % of charges	$66	$68	$20	30%	—	$44 – $94
23	Kaiser kaiser_hmo-bariatric percent of total billed charges · outpatientfrom % of charges	$66	$68	$20	30%	—	$44 – $94
24	Kaiser kaiser_hmo-gcs percent of total billed charges · outpatientfrom % of charges	$66	$68	$20	30%	—	$44 – $94
25	Kaiser kaiser_hmo-gpg/noas percent of total billed charges · outpatientfrom % of charges	$66	$68	$20	30%	—	$44 – $94

Page 1 of 3 · 57 rates

Last updated: Feb 14, 2026

Compare to other hospitals

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.