Affinity product, billed per square centimeter at Samaritan Hospital

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

MEMBRANE AFFINITY FRESH AMNIOTIC 2.5X2.5CM -COST PER SQ CM

Troy, NY

See all hospitals reporting HCPCS Q4159 →

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Pricing by billing methodology

Price type

How this price compares nationally

Samaritan Hospital’s median price of $372 is 5% above the median hospital's median price ($356), higher than 52% of the 1,417 hospitals reporting HCPCS Q4159. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS Q4159 at Samaritan Hospital

Negotiated rates from the hospital’s own file: 12 payers, 17 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 medicare advantage facility · percent of total billed charges · bothfrom % of charges	$124	$124	—	—	—	$124 – $124
2	UnitedHealthcare uhc essential plan medicaid facility · percent of total billed charges · bothfrom % of charges	$198	$198	—	—	—	$198 – $198
3	UnitedHealthcare united healthcare medicaid harp chip facility · percent of total billed charges · bothfrom % of charges	$198	$198	—	—	—	$198 – $198
4	Excellus blue shield of ne new york medicare adv facility · percent of total billed charges · bothfrom % of charges	$248	$248	—	—	—	$248 – $248
5	Highmark blue shield of ne new york medicare adv facility · percent of total billed charges · bothfrom % of charges	$248	$248	—	—	—	$248 – $248
6	Anthem empire bcbs blue access facility · percent of total billed charges · bothfrom % of charges	$372	$372	—	—	—	$372 – $372
7	Anthem empire bcbs hmo epo ppo indemnity facility · percent of total billed charges · bothfrom % of charges	$372	$372	—	—	—	$372 – $372
8	Blue Cross Blue Shield empire bcbs hmo epo ppo indemnity facility · percent of total billed charges · bothfrom % of charges	$372	$372	—	—	—	$372 – $372
9	UnitedHealthcare empire bcbs hmo epo ppo indemnity facility · percent of total billed charges · bothfrom % of charges	$372	$372	—	—	—	$372 – $372
10	WellCare wellcare ep 1&2 medicaid facility · percent of total billed charges · bothfrom % of charges	$372	$372	—	—	—	$372 – $372
11	Wellmark empire bcbs hmo epo ppo indemnity facility · percent of total billed charges · bothfrom % of charges	$372	$372	—	—	—	$372 – $372
12	First Health first health facility · percent of total billed charges · bothfrom % of charges	$396	$396	—	—	—	$396 – $396
13	Cigna cigna facility · percent of total billed charges · bothfrom % of charges	$421	$421	—	—	—	$421 – $421
14	MultiPlan beech street facility · percent of total billed charges · bothfrom % of charges	$446	$446	—	—	—	$446 – $446
15	MultiPlan multiplan facility · percent of total billed charges · bothfrom % of charges	$446	$446	—	—	—	$446 – $446
16	Phcs multiplan facility · percent of total billed charges · bothfrom % of charges	$446	$446	—	—	—	$446 – $446
17	UnitedHealthcare united healthcare facility · percent of total billed charges · bothfrom % of charges	$496	$496	—	—	—	$496 – $496

Last updated: Mar 31, 2026

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