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
$122
Average
$1.1k
Median
$690
High
$4.2k
Each hospital's average Devoted rate, under the methodology and billing class chosen below.
33 hospitals; the 90th percentile is 11.2× 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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34 hospital rates
iThe hospitals that file a Devoted 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 | Banner Payson Medical Center Payson, AZ facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1.7k | $2.0k | $1.4k | 71% | — | $383 – $4.2k |
| 2 | Boulder Community Health Lafayette, CO facility · percent of total billed charges · inpatientfrom % of charges | 1 | $646 | $646 | $85 | 13% | — | $562 – $731 |
| 3 | Boulder Community Health Lafayette, CO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $646 | $646 | $85 | 13% | — | $562 – $731 |
| 4 | Bullhead City Hospital Corporation City, AZ facility · other · outpatient | 1 | $1.9k | $1.9k | $809 | 42% | — | $1.1k – $2.7k |
| 5 | Butler Healthcare Providers_ DBA Butler Memorial Hospital Butler, PA facility · percent of total billed charges · inpatientfrom % of charges | 1 | $267 | $298 | $120 | 40% | — | $168 – $458 |
| 6 | Dickenson Community Hospital CLINTWOOD, VA percent of total billed charges · bothfrom % of charges | 1 | $1.1k | $1.8k | $922 | 52% | — | $1.1k – $3.1k |
| 7 | Dukes Health System LLC Peru, IN facility · fee schedule · outpatient | 1 | $690 | $690 | — | — | — | $690 – $690 |
| 8 | East Cooper Medical Center LLC Mt Pleasant, SC percent of total billed charges · bothfrom % of charges | 2 | $1.6k | $2.3k | $2.0k | 85% | — | $647 – $5.5k |
| 9 | East Morgan County Hospital Brush, CO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1.8k | $2.1k | $1.5k | 71% | — | $402 – $4.4k |
| 10 | Hancock County Hospital SNEEDVILLE, TN percent of total billed charges · bothfrom % of charges | 1 | $2.6k | $4.2k | $2.2k | 52% | — | $2.6k – $7.3k |
| 11 | Hilton Head Medical Center LLC Hilton Head Island, SC percent of total billed charges · bothfrom % of charges | 2 | $532 | $532 | $56 | 10% | — | $476 – $587 |
| 12 | Honokaa Hospital and Skilled Nursing Facility Honokaa, HI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $855 | $855 | — | — | — | $855 – $855 |
| 13 | Johnson County Community Hospital MOUNTAIN CITY, TN percent of total billed charges · bothfrom % of charges | 1 | $1.1k | $1.7k | $891 | 52% | — | $1.1k – $3.0k |
| 14 | Kau Hospital Pahala, HI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $346 | $346 | — | — | — | $346 – $346 |
| 15 | Lee County Community Hospital PENNINGTON GAP, VA percent of total billed charges · bothfrom % of charges | 1 | $821 | $1.3k | $676 | 52% | — | $814 – $2.3k |
| 16 | MID-VALLEY HEALTHCARE INC Lebanon, OR facility · percent of total billed charges · outpatientfrom % of charges | 1 | $224 | $217 | $101 | 46% | — | $20 – $373 |
| 17 | Mercy Hospital Aurora Aurora, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $122 | $122 | — | — | — | $122 – $122 |
| 18 | Mercy Hospital Booneville Booneville, AR facility · percent of total billed charges · outpatientfrom % of charges | 1 | $141 | $141 | — | — | — | $141 – $141 |
| 19 | Mercy Hospital Carthage Carthage, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $160 | $160 | $31 | 19% | — | $129 – $191 |
| 20 | Mercy Hospital Ozark Ozark, AR facility · percent of total billed charges · outpatientfrom % of charges | 1 | $200 | $200 | — | — | — | $200 – $200 |
| 21 | NORTHWEST MEDICAL FOUNDATION OF TILLAMOOK Tillamook, OR percent of total billed charges · outpatientfrom % of charges | 1 | $1.8k | $1.7k | $936 | 56% | — | $226 – $3.6k |
| 22 | Northwest Hospital LLC Tucson, AZ facility · other · outpatient | 1 | $430 | $492 | $329 | 67% | — | $123 – $922 |
| 23 | Northwest Sahurita Hospital LLC Tucson, AZ facility · other · outpatient | 1 | $430 | $492 | $329 | 67% | — | $123 – $922 |
| 24 | Oro Valley Hospital LLC Tucson, AZ facility · other · outpatient | 1 | $430 | $492 | $329 | 67% | — | $123 – $922 |
| 25 | Page Hospital Page, AZ facility · percent of total billed charges · outpatientfrom % of charges | 1 | $2.2k | $2.6k | $1.8k | 71% | — | $496 – $5.4k |
← Payers reporting HCPCS C1765 · Snapshot 20261111T120946Z-9134e7f7