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
Graft Split Face 1st 100 Sq Cm Chld
Low
$4
Average
$4.0k
Median
$3.5k
High
$43.7k
Each hospital's average Aetna rate, under the methodology and billing class chosen below.
1396 hospitals; the 90th percentile is 5.3× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
Filter by billing methodology
Filter by billing class
2,062 hospital rates
iThe hospitals that file a Aetna rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Barnes Jewish Hospital St. Louis, MO other · outpatient | 2 | $3.5k | $3.5k | — | — | 3–30 | $3.5k – $3.5k |
| 2 | MEMORIAL HEALTH UNIVERSITY MEDICAL CENTER SAVANNAH, GA percent of total billed charges · outpatientfrom % of charges | 1 | $1.1k | $1.1k | — | — | 3–30 | $1.1k – $1.1k |
| 3 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY facility · case rate · outpatient | 1 | $5.5k | $5.5k | — | — | 2–20 | $5.5k – $5.5k |
| 4 | Indiana University Health North Hospital Inc. Carmel, IN percent of total billed charges · outpatientfrom % of charges | 6 | $11.2k | $19.6k | $18.5k | 94% | 2–20 | $7.7k – $64.3k |
| 5 | Massachusetts General Hospital Boston, MA percent of total billed charges · outpatientfrom % of charges | 1 | $3.8k | $3.8k | $1.7k | 44% | 2–20 | $2.2k – $5.5k |
| 6 | BATON ROUGE GENERAL MEDICAL CENTER BATON ROUGE, LA fee schedule · outpatient | 1 | $3.4k | $3.4k | — | — | 1–10 | $3.4k – $3.4k |
| 7 | Barnes Jewish Hospital St. Louis, MO case rate · outpatient | 1 | $8.5k | $8.5k | — | — | 1–10 | $8.5k – $8.5k |
| 8 | DIGNITY COMMUNITY CARE Chandler, AZ fee schedule · outpatient | 1 | $805 | $805 | — | — | 1–10 | $805 – $805 |
| 9 | Fairview Health Services Minneapolis, MN other · inpatient | 1 | $2.9k | $2.9k | — | — | 1–10 | $2.9k – $2.9k |
| 10 | Fairview Health Services Minneapolis, MN percent of total billed charges · outpatientfrom % of charges | 1 | $6.9k | $6.9k | — | — | 1–10 | $6.9k – $6.9k |
| 11 | Inova Fairfax Hospital Falls Church, VA fee schedule · both | 5 | $3.6k | $3.4k | $313 | 9% | 1–10 | $2.9k – $3.7k |
| 12 | METHODIST LEBONHEUR CHILDRENS HOSP TN 38301; 7691 POPLAR AVE. MEMPHIS, TN percent of total billed charges · outpatientfrom % of charges | 1 | $16.9k | $16.9k | — | — | 1–10 | $16.9k – $16.9k |
| 13 | MIDSTATE MEDICAL CENTER MERIDEN, CT other · outpatient | 1 | $1.5k | $1.5k | — | — | 1–10 | $1.5k – $1.5k |
| 14 | Massachusetts Eye and Ear Boston, MA percent of total billed charges · bothfrom % of charges | 1 | $493 | $493 | — | — | 1–10 | $493 – $493 |
| 15 | Mayo Clinic Rochester, MN facility · percent of total billed charges · bothfrom % of charges | 3 | $5.4k | $5.4k | — | — | 1–10 | $5.4k – $5.4k |
| 16 | Mayo Clinic Rochester, MN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $18.6k | $18.6k | — | — | 1–10 | $18.6k – $18.6k |
| 17 | Mayo Clinic Florida Jacksonville, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $3.5k | $3.5k | — | — | 1–10 | $3.5k – $3.5k |
| 18 | Memorial Hospital for Cancer and Allied Diseases New York, NY fee schedule · outpatient | 2 | $7.5k | $7.4k | $495 | 7% | 1–10 | $6.8k – $8.0k |
| 19 | Memorial Hospital for Cancer and Allied Diseases Montvale, NJ fee schedule · outpatient | 2 | $7.5k | $7.3k | $354 | 5% | 1–10 | $6.8k – $7.5k |
| 20 | Memorial Hospital for Cancer and Allied Diseases Hauppauge, NY fee schedule · outpatient | 2 | $7.5k | $7.3k | $354 | 5% | 1–10 | $6.8k – $7.5k |
| 21 | Memorial Hospital for Cancer and Allied Diseases Middletown, NJ fee schedule · outpatient | 2 | $7.5k | $7.3k | $354 | 5% | 1–10 | $6.8k – $7.5k |
| 22 | North Memorial Health Care Robbinsdale, MN professional · percent of total billed charges · bothfrom % of charges | 1 | $2.2k | $2.2k | — | — | 1–10 | $2.2k – $2.2k |
| 23 | Parkland Health Dallas, TX facility · percent of total billed charges · bothfrom % of charges | 1 | $4.9k | $4.9k | — | — | 1–10 | $4.9k – $4.9k |
| 24 | Parkland Health Dallas, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $20.3k | $21.1k | $4.0k | 19% | 1–10 | $16.8k – $27.1k |
| 25 | Saint Francis Hospital and Medical Center Hartford, CT facility · other · outpatient | 1 | $4.2k | $4.2k | — | — | 1–10 | $4.2k – $4.2k |
← Payers reporting CPT 15120 · Snapshot 20261112T124536Z-e251e855