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
HH 4x4 Sponge Gauze
Low
$0
Average
$16
Median
$3
High
$57
Filter by billing methodology
Reflects a payer-specific billing methodology not covered by the standard categories.
Showing only prices reported under the other methodology. Choose another in the filter above to change the chart. 12 hospitals; the 90th percentile is 311.9× 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.
Click a bar to filter the hospitals table to that price range.
| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | Benefis Community Care, Inc Great Falls, MT | $0 | $0 | — | — | — | $0 – $0 |
| 2 | Ochsner Clinic Foundation Orleans, LA | $44 | $46 | $8 | 19% | — | $37 – $66 |
| 3 | East Baton Rouge Medical Center, Llc Baton Rouge, LA | $58 | $57 | $9 | 15% | — | $25 – $69 |
| 4 | Henry Ford Health Rochester, MI | $0 | $0 | $0 | 4% | — | $0 – $0 |
| 5 | SwedishAmerican Hospital Rockford, IL | $0 | $0 | $0 | 6% | — | $0 – $383 |
| 6 | Nationwide Children's Hospital Columbus, OH | $26 | $26 | — | — | — | $26 – $26 |
| 7 | Nationwide Children's Hospital Toledo, Llc Toledo, OH | $19 | $19 | $0 | 0% | — | $19 – $19 |
| 8 | St Josephs Hospital Hospital Sisters Third Order Of St Francis Breese, IL | $5 | $5 | — | — | — | $2 – $6 |
| 9 | Heritage Valley Sewickley MCKEES ROCKS, PA | $0 | $0 | — | — | — | $0 – $1 |
| 10 | Heritage Valley Beaver BEAVER, PA | $0 | $0 | — | — | — | $0 – $1 |
Ask Claude or any MCP client for HCPCS A6402 pricing at a specific hospital — see how to connect.