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
BARRIER ADHES 3X5IN PROC PK BIORESORB MEMBRANE SEPRAFILM SOD HYALURONATE
Low
$1
Average
$1.6k
Median
$1.0k
High
$58.0k
Each hospital's average Aetna rate, under the methodology and billing class chosen below.
1057 hospitals; the 90th percentile is 11.5× 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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1,504 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 | Texas Health Presbyterian Hospital Dallas Dallas, TX percent of total billed charges · outpatientfrom % of charges | 4 | $3.3k | $3.8k | $2.3k | 62% | 70–700 | $284 – $10.8k |
| 2 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 3 | $772 | $1.5k | $1.6k | 107% | 18–180 | $504 – $5.9k |
| 3 | Mishawaka Medical Center Mishawaka, IN facility · percent of total billed charges · bothfrom % of charges | 1 | $591 | $1.1k | $1.3k | 112% | 9–90 | $394 – $4.5k |
| 4 | Samaritan Hospital Troy, NY facility · percent of total billed charges · bothfrom % of charges | 1 | $364 | $688 | $775 | 113% | 9–90 | $207 – $2.8k |
| 5 | BAPTIST HEALTHCARE SYSTEM INC Corbin, KY percent of total billed charges · outpatientfrom % of charges | 2 | $1.7k | $3.8k | $6.8k | 179% | 8–80 | $155 – $21.6k |
| 6 | BAPTIST HEALTHCARE SYSTEM INC Elizabethtown, KY percent of total billed charges · outpatientfrom % of charges | 3 | $586 | $1.7k | $2.3k | 139% | 4–40 | $174 – $7.6k |
| 7 | PRISMA HEALTH BAPTIST COLUMBIA HOSPITAL COLUMBIA, SC percent of total billed charges · bothfrom % of charges | 2 | $1.6k | $2.2k | $1.1k | 51% | 3–30 | $1.1k – $3.9k |
| 8 | PRISMA HEALTH BAPTIST PARKRIDGE HOSPITAL COLUMBIA, SC percent of total billed charges · bothfrom % of charges | 2 | $1.6k | $2.2k | $1.1k | 51% | 3–30 | $1.1k – $3.9k |
| 9 | PRISMA HEALTH RICHLAND HOSPITAL COLUMBIA, SC percent of total billed charges · bothfrom % of charges | 2 | $1.6k | $2.2k | $1.1k | 51% | 3–30 | $1.1k – $3.9k |
| 10 | University of Virginia Haymarket Medical Center Haymarket, VA percent of total billed charges · bothfrom % of charges | 1 | $3.8k | $3.7k | $2.3k | 63% | 3–30 | $776 – $6.5k |
| 11 | Hackensack Meridian Mountainside Medical Center Montclair, NJ facility · percent of total billed charges · bothfrom % of charges | 3 | $709 | $684 | $172 | 25% | 2–20 | $427 – $936 |
| 12 | Salem Hospital Salem, MA percent of total billed charges · bothfrom % of charges | 1 | $541 | $541 | $33 | 6% | 2–20 | $508 – $575 |
| 13 | ALASKA REGIONAL HOSPITAL Anchorage, AK percent of total billed charges · outpatientfrom % of charges | 1 | $3.3k | $3.3k | — | — | 1–10 | $3.3k – $3.3k |
| 14 | FORT SANDERS REGIONAL MEDICAL CENTER Knoxville, TN percent of total billed charges · outpatientfrom % of charges | 1 | $1.8k | $1.8k | — | — | 1–10 | $1.8k – $1.8k |
| 15 | MCLAREN GREATER LANSING LANSING, MI percent of total billed chargesfrom % of charges | 1 | $1.1k | $1.1k | — | — | 1–10 | $1.1k – $1.1k |
| 16 | NYU Langone Brooklyn, NY percent of total billed charges · bothfrom % of charges | 25 | $1.1k | $1.1k | — | — | 1–10 | $1.1k – $1.1k |
| 17 | Samaritan Medical Center Watertown, NY facility · other · inpatient | 1 | $825 | $825 | — | — | 1–10 | $825 – $825 |
| 18 | Samaritan Medical Center Watertown, NY facility · other · outpatient | 1 | $825 | $825 | — | — | 1–10 | $825 – $825 |
| 19 | ACADIA GENERAL HOSPITAL, INC 1305 CROWLEY RAYNE HWY other · inpatient | 1 | $2.3k | $2.2k | $1.1k | 47% | — | $449 – $4.4k |
| 20 | ACADIA GENERAL HOSPITAL, INC 1305 CROWLEY RAYNE HWY other · outpatient | 1 | $2.3k | $2.2k | $1.1k | 47% | — | $449 – $4.4k |
| 21 | ADVENTIST HEALTH CLEARLAKE HOSPITAL INC Clearlake, CA percent of total billed charges · outpatientfrom % of charges | 1 | $1.5k | $1.5k | $865 | 57% | — | $664 – $2.4k |
| 22 | ADVENTIST HEALTH DELANO Delano, CA percent of total billed charges · outpatientfrom % of charges | 1 | $1.1k | $1.1k | $668 | 62% | — | $403 – $1.7k |
| 23 | ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI Tehachapi, CA percent of total billed charges · outpatientfrom % of charges | 1 | $1.6k | $1.7k | $770 | 46% | — | $759 – $3.4k |
| 24 | ADVENTIST HEALTH TULARE Tulare, CA percent of total billed charges · outpatientfrom % of charges | 1 | $2.0k | $1.9k | $1.1k | 55% | — | $293 – $4.1k |
| 25 | AGH LAVEEN LLC Phoenix, AZ case rate · outpatient | 2 | $182 | $182 | — | — | — | $182 – $182 |
← Payers reporting HCPCS C1765 · Snapshot 20261111T120946Z-9134e7f7