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
Marigen pacto, per square centimeter (add-on, list separately in addition to primary procedure)
Low
$33
Average
$150
Median
$130
High
$459
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
37 payers; the 90th percentile is 3.0× the 10th. Each bar is a price range and its height is how many payers fall in it. Hover a bar, or a row in the ladder, for details.
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| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | UnitedHealthcare fee schedule · outpatient · +7 other terms | 221 | $210 | $224 | $75 | 33% | — | $8 – $483 |
| 2 | Aetna fee schedule · outpatient · +7 other terms | 59 | $132 | $127 | $59 | 47% | — | $24 – $444 |
| 3 | Humana fee schedule · outpatient · +6 other terms | 42 | $127 | $130 | $24 | 19% | — | $32 – $171 |
| 4 | Blue Cross Blue Shield fee schedule · outpatient · +4 other terms | 37 | $92 | $89 | $32 | 36% | — | $8 – $170 |
| 5 | Molina facility · fee schedule · outpatient · +5 other terms | 33 | $118 | $129 | $51 | 39% | — | $65 – $319 |
| 6 | WellCare fee schedule · outpatient · +5 other terms | 31 | $140 | $134 | $34 | 26% | — | $8 – $158 |
| 7 | Cigna fee schedule · outpatient · +3 other terms | 30 | $206 | $254 | $179 | 71% | — | $23 – $644 |
| 8 | Anthem facility · fee schedule · outpatient · +5 other terms | 23 | $127 | $179 | $84 | 47% | — | $49 – $349 |
| 9 | Devoted facility · fee schedule · outpatient · +3 other terms | 23 | $118 | $124 | $11 | 9% | — | $118 – $143 |
| 10 | Kaiser fee schedule · outpatient · +2 other terms | 22 | $125 | $307 | $247 | 80% | — | $125 – $1000 |
| 11 | Ambetter fee schedule · outpatient · +2 other terms | 18 | $256 | $263 | $41 | 16% | — | $218 – $351 |
| 12 | Medicare fee schedule · outpatient | 18 | $125 | $125 | — | — | — | $125 – $125 |
| 13 | Caresource fee schedule · outpatient · +2 other terms | 14 | $51 | $76 | $59 | 78% | — | $15 – $199 |
| 14 | Medical Mutual facility · fee schedule · outpatient · +1 other terms | 12 | $118 | $123 | $13 | 11% | — | $118 – $167 |
| 15 | Optum fee schedule · outpatient | 12 | $125 | $180 | $125 | 69% | — | $125 – $459 |
| 16 | Regence fee schedule · outpatient · +2 other terms | 9 | $146 | $145 | $3 | 2% | — | $140 – $150 |
| 17 | Excellus fee schedule · outpatient · +2 other terms | 6 | $236 | $230 | $60 | 26% | — | $127 – $351 |
| 18 | Aetna Better Health facility · fee schedule · outpatient | 5 | $68 | $68 | $1 | 1% | — | $68 – $70 |
| 19 | Highmark fee schedule · outpatient · +3 other terms | 5 | $155 | $179 | $57 | 32% | — | $127 – $279 |
| 20 | Tricare facility · fee schedule · outpatient | 4 | $121 | $118 | $5 | 4% | — | $109 – $121 |
| 21 | First Health professional · fee schedule · both | 3 | $77 | $77 | — | — | — | $77 – $77 |
| 22 | Bcbs Al facility · case rate · outpatient | 2 | $125 | $125 | — | — | — | $125 – $125 |
| 23 | Bcbs Id fee schedule · outpatient | 2 | $140 | $140 | — | — | — | $140 – $140 |
| 24 | Bcbs Ks fee schedule · outpatient | 2 | $125 | $125 | — | — | — | $125 – $125 |
| 25 | Bcbs Mi facility · case rate · outpatient · +1 other terms | 2 | $66 | $66 | — | — | — | $66 – $66 |
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