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
Gauze > 48 sq in w/border
Low
$0
Average
$11
Median
$8
High
$44
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
21 payers; the 90th percentile is 9.9× 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.
Filter by billing methodology
Filter by billing class
| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Aetna fee schedule · outpatient · +7 other terms | 29 | $3 | $4 | $2 | 60% | — | $2 – $11 |
| 2 | Blue Cross Blue Shield facility · fee schedule · outpatient · +6 other terms | 25 | $2 | $34 | $65 | 191% | — | $0 – $190 |
| 3 | UnitedHealthcare fee schedule · outpatient · +5 other terms | 16 | $6 | $5 | $2 | 38% | — | $2 – $6 |
| 4 | Anthem facility · case rate · outpatient · +5 other terms | 15 | $15 | $17 | $4 | 23% | — | $10 – $26 |
| 5 | Caresource facility · case rate · outpatient · +1 other terms | 15 | $16 | $17 | $4 | 23% | — | $10 – $27 |
| 6 | Molina facility · case rate · outpatient · +3 other terms | 15 | $15 | $17 | $4 | 23% | — | $11 – $26 |
| 7 | Wellmark fee schedule · both · +1 other terms | 13 | $5 | $6 | $6 | 95% | — | $5 – $40 |
| 8 | Bcbs Mn fee schedule · outpatient · +3 other terms | 12 | $8 | $5 | $4 | 78% | — | $0 – $10 |
| 9 | Optum facility · case rate · outpatient · +1 other terms | 11 | $14 | $16 | $4 | 22% | — | $13 – $24 |
| 10 | Cigna professional · fee schedule · outpatient · +3 other terms | 10 | $2 | $2 | — | — | — | $2 – $2 |
| 11 | Highmark fee schedule · outpatient · +2 other terms | 10 | $3 | $3 | — | — | — | $3 – $3 |
| 12 | Aetna Better Health fee schedule · inpatient · +1 other terms | 7 | $2 | $2 | — | — | — | $2 – $2 |
| 13 | Humana fee schedule · inpatient · +2 other terms | 5 | $2 | $2 | — | — | — | $2 – $2 |
| 14 | First Health professional · fee schedule · both · +1 other terms | 3 | $2 | $2 | — | — | — | $2 – $2 |
| 15 | Regence percent of total billed charges · bothfrom % of charges | 2 | $14 | $14 | $0 | 1% | — | $14 – $14 |
| 16 | Bcbs Id facility · fee schedule · outpatient · +1 other terms | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 17 | Bcbs Il professional · fee schedule · both | 1 | $40 | $40 | — | — | — | $40 – $40 |
| 18 | Bcbs La facility · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 19 | Bcbs Nc facility · fee schedule · outpatient | 1 | $3 | $3 | $0 | 8% | — | $3 – $3 |
| 20 | Bcbs Nv fee schedule · outpatient | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 21 | Bcbs Vt professional · fee schedule · outpatient | 1 | $3 | $3 | — | — | — | $3 – $3 |
← Hospitals reporting HCPCS A6221 · Snapshot 20261112T181611Z-3fa9fb76