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
$978
Median
$650
High
$9.5k
Each hospital's average Molina rate, under the methodology and billing class chosen below.
246 hospitals; the 90th percentile is 9.2× 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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292 hospital rates
iThe hospitals that file a Molina 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 | BAPTIST HEALTHCARE SYSTEM INC Corbin, KY percent of total billed charges · outpatientfrom % of charges | 1 | $224 | $690 | $849 | 123% | 4–40 | $155 – $2.2k |
| 2 | BAPTIST HEALTHCARE SYSTEM INC Lexington, KY percent of total billed charges · outpatientfrom % of charges | 1 | $252 | $777 | $955 | 123% | 4–40 | $174 – $2.4k |
| 3 | BAPTIST HEALTHCARE SYSTEM INC Paducah, KY percent of total billed charges · outpatientfrom % of charges | 1 | $224 | $690 | $849 | 123% | 4–40 | $155 – $2.2k |
| 4 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient | 1 | $176 | $176 | — | — | — | $176 – $176 |
| 5 | AMH Cath Labs LLC Arlington, TX percent of total billed charges · outpatientfrom % of charges | 1 | $554 | $613 | $351 | 57% | — | $66 – $1.5k |
| 6 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH per diem · inpatient | 2 | $5.4k | $5.4k | — | — | — | $5.4k – $5.4k |
| 7 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH percent of total billed charges · inpatientfrom % of charges | 2 | $999 | $999 | $514 | 51% | — | $485 – $1.5k |
| 8 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH percent of total billed charges · outpatientfrom % of charges | 4 | $743 | $776 | $414 | 53% | — | $334 – $1.4k |
| 9 | Adena Fayette Medical Center Washington Court House, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1.7k | $1.4k | $498 | 35% | — | $476 – $1.8k |
| 10 | Aurora BayCare Medical Center Green Bay, WI percent of total billed charges · outpatientfrom % of charges | 1 | $1.1k | $1.1k | $593 | 54% | — | $497 – $1.7k |
| 11 | Aurora Lakeland Medical Center Elkhorn, WI percent of total billed charges · outpatientfrom % of charges | 1 | $606 | $606 | — | — | — | $606 – $606 |
| 12 | Aurora Medical Center Burlington Burlington, WI percent of total billed charges · outpatientfrom % of charges | 1 | $529 | $529 | — | — | — | $529 – $529 |
| 13 | Aurora Medical Center Fond du Lac Fond Du Lac, WI percent of total billed charges · outpatientfrom % of charges | 1 | $606 | $606 | — | — | — | $606 – $606 |
| 14 | Aurora Medical Center Oshkosh Oshkosh, WI percent of total billed charges · outpatientfrom % of charges | 1 | $606 | $917 | $534 | 58% | — | $477 – $1.7k |
| 15 | Aurora Medical Center Sheboygan County Sheboygan, WI percent of total billed charges · outpatientfrom % of charges | 1 | $606 | $606 | — | — | — | $606 – $606 |
| 16 | Aurora Medical Center Summit Summit, WI percent of total billed charges · outpatientfrom % of charges | 1 | $566 | $566 | — | — | — | $566 – $566 |
| 17 | Aurora Sinai Medical Center of Aurora Health Care Metro Inc Milwaukee, WI percent of total billed charges · outpatientfrom % of charges | 1 | $768 | $768 | $162 | 21% | — | $606 – $929 |
| 18 | Aurora St Lukes Medical Center of Aurora Health Care Metro Inc Milwaukee, WI percent of total billed charges · outpatientfrom % of charges | 1 | $2.2k | $2.2k | $920 | 42% | — | $1.3k – $3.1k |
| 19 | Aurora St Lukes South Shore of Aurora Health Care Metro Inc Cudahy, WI percent of total billed charges · outpatientfrom % of charges | 1 | $3.2k | $3.2k | — | — | — | $3.2k – $3.2k |
| 20 | Aurora West Allis Medical Center West Allis, WI percent of total billed charges · outpatientfrom % of charges | 1 | $2.1k | $2.1k | $1.1k | 55% | — | $933 – $3.2k |
| 21 | BAPTIST HEALTHCARE SYSTEM INC Elizabethtown, KY percent of total billed charges · outpatientfrom % of charges | 1 | $252 | $777 | $955 | 123% | — | $174 – $2.4k |
| 22 | BAPTIST HEALTHCARE SYSTEM INC Richmond, KY percent of total billed charges · outpatientfrom % of charges | 1 | $252 | $777 | $955 | 123% | — | $174 – $2.4k |
| 23 | BAPTIST HEALTHCARE SYSTEM INC Grange, KY percent of total billed charges · outpatientfrom % of charges | 1 | $252 | $777 | $955 | 123% | — | $174 – $2.4k |
| 24 | BAPTIST HEALTHCARE SYSTEM INC. Louisville, KY percent of total billed charges · outpatientfrom % of charges | 1 | $308 | $949 | $1.2k | 123% | — | $213 – $3.0k |
| 25 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE other · outpatient | 1 | $13.4k | $13.4k | — | — | — | $13.4k – $13.4k |
← Payers reporting HCPCS C1765 · Snapshot 20261111T120946Z-9134e7f7