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
HB-Dress Gauze 4x4
Low
$0
Average
$2
Median
$0
High
$74
Each hospital's average Anthem rate, under the methodology and billing class chosen below.
150 hospitals; the 90th percentile is 115.2× 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.
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171 hospital rates
iThe hospitals that file a Anthem 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 | University of Wisconsin Hospital and Clinics Authority WI 53718; 1675 Highland Ave Madison, WI percent of total billed chargesfrom % of charges | 4 | $5 | $5 | $4 | 72% | 447–645 | $0 – $13 |
| 2 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 3 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · fee schedule · outpatient | 2 | $0 | $0 | $0 | 11% | — | $0 – $0 |
| 4 | Acadia Hospital Bangor, ME facility · fee schedule · outpatient | 2 | $0 | $0 | $0 | 25% | — | $0 – $0 |
| 5 | Acadia Hospital Bangor, ME professional · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 6 | Alta Newport Hospital, LLC Tustin, CA facility · case rate · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 7 | BRIGHTON COMMUNITY HOSPITAL ASSOCIATION DBA INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL BRIGHTON, CO facility · fee schedule · outpatient | 4 | $0 | $0 | — | — | — | $0 – $0 |
| 8 | Blue Hill Memorial Hospital Hill, ME professional · fee schedule · outpatient | 2 | $0 | $0 | $0 | 33% | — | $0 – $0 |
| 9 | Boulder Community Health Lafayette, CO facility · case rate · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 10 | Boulder Community Health Lafayette, CO facility · fee schedule · outpatient | 2 | $0 | $0 | $0 | 43% | — | $0 – $0 |
| 11 | Boulder Community Health Lafayette, CO professional · fee schedule · both | 2 | $0 | $0 | — | — | — | $0 – $0 |
| 12 | CATHOLIC HEALTH INIATIVES COLORADO Westminster, CO fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 13 | CATHOLIC HEALTH INITIATIVES COLORADO Pueblo, CO fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 14 | CATHOLIC HEALTH INITIATIVES COLORADO Colorado Springs, CO fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 15 | CATHOLIC HEALTH INITIATIVES COLORADO Frisco, CO fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 16 | CATHOLIC HEALTH INITIATIVES COLORADO Durango, CO fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 17 | CATHOLIC HEALTH INITIATIVES COLORADO Lakewood, CO fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 18 | CATHOLIC HEALTH INITIATIVES COLORADO Colorado Springs, CO fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 19 | CATHOLIC HEALTH INITIATIVES COLORADO Fort Morgan, CO fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 20 | CATHOLIC MEDICAL CENTER MANCHESTER, NH fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 21 | CENTENNIAL HOSPITAL A CAMPUS OF TMCA ENGLEWOOD, CO fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 22 | CLEVELAND CLINIC AVON HOSPITAL Avon, OH facility · case rate · outpatient | 1 | $14 | $14 | — | — | — | $14 – $14 |
| 23 | CLEVELAND CLINIC AVON HOSPITAL Avon, OH facility · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 24 | CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHABILITATION Cleveland, OH facility · case rate · outpatient | 1 | $26 | $26 | — | — | — | $26 – $26 |
| 25 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Mentor, OH facility · case rate · outpatient | 1 | $16 | $16 | — | — | — | $16 – $16 |
← Payers reporting HCPCS A6216 · Snapshot 20261111T120946Z-9134e7f7