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
Elyria, OH
See all hospitals reporting HCPCS Q4239 →Price type
University Hospitals Health System’s median price of $118 is 53% below the median hospital's median price ($252), higher than 10% 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: 11 payers, 15 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 medicare advantage facility · fee schedule · outpatient | $118 | $118 | — | — | — | $118 – $118 |
| 2 | Anthem medicare advantage facility · fee schedule · outpatient | $118 | $118 | — | — | — | $118 – $118 |
| 3 | Cigna medicare advantage facility · fee schedule · outpatient | $118 | $118 | — | — | — | $118 – $118 |
| 4 | Devoted medicare advantage facility · fee schedule · outpatient | $118 | $118 | — | — | — | $118 – $118 |
| 5 | Humana medicare advantage facility · fee schedule · outpatient | $118 | $118 | — | — | — | $118 – $118 |
| 6 | Medical Mutual medicare advantage facility · fee schedule · outpatient | $118 | $118 | — | — | — | $118 – $118 |
| 7 | Molina medicare advantage facility · fee schedule · outpatient | $118 | $118 | — | — | — | $118 – $118 |
| 8 | UnitedHealthcare medicare advantage facility · fee schedule · outpatient | $118 | $118 | — | — | — | $118 – $118 |
| 9 | WellCare medicare advantage facility · fee schedule · outpatient | $118 | $118 | — | — | — | $118 – $118 |
| 10 | Ambetter commercial facility · fee schedule · outpatient | $212 | $212 | — | — | — | $212 – $212 |
| 11 | Caresource marketplace facility · fee schedule · outpatient | $212 | $212 | — | — | — | $212 – $212 |
| 12 | Medical Mutual medflex commercial facility · fee schedule · outpatient | $4.0k | $4.0k | — | — | — | $4.0k – $4.0k |
| 13 | Medical Mutual supermed hmo facility · fee schedule · outpatient | $4.4k | $4.4k | — | — | — | $4.4k – $4.4k |
| 14 | Medical Mutual nas commercial facility · fee schedule · outpatient | $4.9k | $4.9k | — | — | — | $4.9k – $4.9k |
| 15 | Cigna oap commercial facility · fee schedule · outpatient | $8.0k | $8.0k | — | — | — | $8.0k – $8.0k |
Last updated: Jul 14, 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.