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
HC Graft Tiss 2x3cm Amnioxcl <6 Sq Cm>
McCall, ID
See all hospitals reporting HCPCS Q4137 →Price type
St Luke's McCall, LTD’s median price of $315 is 98% above the median hospital's median price ($159), higher than 79% of the 1,253 hospitals reporting HCPCS Q4137. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 8 payers, 13 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 | Cigna hb mccall cigna fee schedule · outpatient | $115 | $115 | — | — | — | $115 – $115 |
| 2 | Molina hb mccall molina mmcp percent of total billed charges · bothfrom % of charges | $208 | $208 | — | — | — | $208 – $208 |
| 3 | Regence hb mccall medicare advantage percent of total billed charges · bothfrom % of charges | $208 | $208 | — | — | — | $208 – $208 |
| 4 | Blue Cross Blue Shield hb mccall bci true & secure med adv percent of total billed charges · bothfrom % of charges | $210 | $210 | — | — | — | $210 – $210 |
| 5 | Molina hb mccall molina med adv percent of total billed charges · bothfrom % of charges | $212 | $212 | — | — | — | $212 – $212 |
| 6 | Aetna hb mccall aetna med adv percent of total billed charges · bothfrom % of charges | $228 | $228 | — | — | — | $228 – $228 |
| 7 | Bcbs Id hb mccall bci percent of total billed charges · inpatientfrom % of charges | $315 | $315 | — | — | — | $315 – $315 |
| 8 | Blue Cross Blue Shield hb mccall bci percent of total billed charges · inpatientfrom % of charges | $315 | $315 | — | — | — | $315 – $315 |
| 9 | Aetna hb mccall aetna trinity health (st al's) percent of total billed charges · bothfrom % of charges | $322 | $322 | — | — | — | $322 – $322 |
| 10 | Cigna hb mccall cigna percent of total billed charges · inpatientfrom % of charges | $333 | $333 | — | — | — | $333 – $333 |
| 11 | Aetna hb mccall bp aetna percent of total billed charges · bothfrom % of charges | $340 | $340 | — | — | — | $340 – $340 |
| 12 | First Health hb mccall first choice health percent of total billed charges · bothfrom % of charges | $340 | $340 | — | — | — | $340 – $340 |
| 13 | UnitedHealthcare hb mccall united healthcare percent of total billed charges · bothfrom % of charges | $344 | $344 | — | — | — | $344 – $344 |
Last updated: Mar 25, 2026
See Amniotic membrane 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.