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
Jasper, TX
See all hospitals reporting HCPCS Q4239 →Price type
Southeast Texas - Jasper Memorial’s median price of $9 is 96% below the median hospital's median price ($252), higher than 4% of the 924 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: 2 payers, 7 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 | Bcbs Tx blue advantage hmo fee schedule · outpatient | $7 | $7 | — | — | — | $7 – $7 |
| 2 | Bcbs Tx heb fee schedule · outpatient | $8 | $8 | — | — | — | $8 – $8 |
| 3 | Bcbs Tx hmo fee schedule · outpatient | $8 | $8 | — | — | — | $8 – $8 |
| 4 | Bcbs Tx traditional fee schedule · outpatient | $9 | $9 | — | — | — | $9 – $9 |
| 5 | Bcbs Tx ppo fee schedule · outpatient | $10 | $10 | — | — | — | $10 – $10 |
| 6 | UnitedHealthcare all payer fee schedule · outpatient | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
| 7 | UnitedHealthcare hix fee schedule · outpatient | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
Last updated: Jan 13, 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.