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
Saint Louis, MO
See all hospitals reporting HCPCS Q4239 →Price type
SSM-SLUH, Inc.’s median price of $132 is 48% below the median hospital's median price ($252), higher than 24% 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: 5 payers, 10 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 anthem medicare managed care plan fee schedule · outpatient | $122 | $122 | — | — | — | $122 – $122 |
| 2 | Aetna medicare managed care plan fee schedule · outpatient | $125 | $125 | — | — | — | $125 – $125 |
| 3 | Humana medicare managed care plan fee schedule · outpatient | $127 | $127 | — | — | — | $127 – $127 |
| 4 | Aetna advantra medicare managed care plan fee schedule · outpatient | $127 | $127 | — | — | — | $127 – $127 |
| 5 | Blue Cross Blue Shield anthem pathway exchange fee schedule · outpatient | $130 | $147 | $55 | 37% | — | $78 – $245 |
| 6 | Oscar exchange fee schedule · outpatient | $150 | $150 | — | — | — | $150 – $150 |
| 7 | Blue Cross Blue Shield anthem blue preferred hmo/pos fee schedule · outpatient | $132 | $150 | $56 | 37% | — | $80 – $251 |
| 8 | Blue Cross Blue Shield anthem blue access choice all commercial plans fee schedule · outpatient | $132 | $155 | $57 | 37% | — | $80 – $251 |
| 9 | Blue Cross Blue Shield anthem blue access ppo fee schedule · outpatient | $191 | $185 | $71 | 39% | — | $86 – $270 |
| 10 | Cigna all commercial plans fee schedule · outpatient | $3.5k | $3.5k | — | — | — | $3.5k – $3.5k |
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.