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
HC LOW COST SKIN SUBSTITUTE APP
Low
$442
Average
$2.6k
Median
$1.1k
High
$8.6k
Each hospital's average Wellmark rate, under the methodology and billing class chosen below.
35 hospitals; the 90th percentile is 13.5× 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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43 hospital rates
iThe hospitals that file a Wellmark 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 | Allen Memorial Hospital Corporation Waterloo, IA case rate · outpatient | 1 | $576 | $576 | — | — | — | $576 – $576 |
| 2 | Central Iowa Hospital Corporation Des Moines, IA case rate · outpatient | 1 | $583 | $583 | — | — | — | $583 – $583 |
| 3 | Grinnell Regional Medical Center Grinnell, IA case rate · outpatient | 1 | $583 | $583 | — | — | — | $583 – $583 |
| 4 | Gundersen Palmer Lutheran Hospital and Clinic Inc West Union, IA facility · case rate · outpatient | 2 | $4.7k | $4.7k | $218 | 5% | — | $4.5k – $4.9k |
| 5 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · percent of total billed charges · bothfrom % of charges | 1 | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 6 | Johnson Memorial Hospital Stafford Springs, CT facility · case rate · both | 1 | $6.6k | $6.6k | — | — | — | $6.6k – $6.6k |
| 7 | Mercy Fitzgerald Hospital Darby, PA facility · fee schedule · both | 1 | $3.5k | $3.5k | — | — | — | $3.5k – $3.5k |
| 8 | Mercy Health Services-Iowa Corp. Mason City, IA facility · fee schedule · both | 1 | $755 | $755 | — | — | — | $755 – $755 |
| 9 | Mercy Health Services-Iowa Corp. Mason City, IA facility · fee schedule · outpatient | 2 | $484 | $574 | $128 | 22% | — | $484 – $755 |
| 10 | Mercy Health Services-Iowa Corp. Mason City, IA facility · other · outpatient | 1 | $434 | $434 | — | — | — | $434 – $434 |
| 11 | MercyOne Genesis Aledo Medical Center Aledo, IL facility · case rate · outpatient | 1 | $5.2k | $5.2k | — | — | — | $5.2k – $5.2k |
| 12 | MercyOne Genesis Davenport Medical Center IA 52803; 2140 53rd Avenue Bettendorf, IA facility · fee schedule · outpatient | 1 | $586 | $586 | — | — | — | $586 – $586 |
| 13 | MercyOne Genesis Davenport West Medical Center Davenport, IA facility · fee schedule · outpatient | 1 | $586 | $586 | — | — | — | $586 – $586 |
| 14 | MercyOne Genesis Silvis Medical Center Silvis, IL facility · case rate · outpatient | 1 | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 15 | MercyOne Genesis Silvis Medical Center Silvis, IL facility · fee schedule · outpatient | 1 | $638 | $638 | — | — | — | $638 – $638 |
| 16 | Meriter Hospital, Inc Madison, WI per diem · outpatient | 1 | $3.9k | $3.9k | — | — | — | $3.9k – $3.9k |
| 17 | Mount Carmel East Reynoldsburg, OH facility · other · both | 1 | $7.4k | $7.4k | — | — | — | $7.4k – $7.4k |
| 18 | Mount Carmel Grove City Grove City, OH facility · other · both | 1 | $7.4k | $7.4k | — | — | — | $7.4k – $7.4k |
| 19 | Mount Carmel St Ann's Lewis Center, OH facility · other · both | 1 | $7.4k | $7.4k | — | — | — | $7.4k – $7.4k |
| 20 | Nazareth Hospital Philadelphia, PA facility · fee schedule · both | 1 | $2.9k | $2.9k | — | — | — | $2.9k – $2.9k |
| 21 | Northwest Iowa Hospital Corporation Sioux City, IA case rate · outpatient | 1 | $608 | $608 | — | — | — | $608 – $608 |
| 22 | Saint Francis Hospital and Medical Center Hartford, CT facility · other · both | 1 | $8.6k | $8.6k | — | — | — | $8.6k – $8.6k |
| 23 | Saint Marys Hospital Waterbury, CT facility · other · both | 1 | $7.3k | $7.3k | — | — | — | $7.3k – $7.3k |
| 24 | Samaritan Hospital Troy, NY facility · other · both | 3 | $4.8k | $4.8k | $865 | 18% | — | $3.8k – $5.9k |
| 25 | St Joseph Mercy Ann Arbor Ypsilanti, MI facility · fee schedule · both | 1 | $495 | $495 | — | — | — | $495 – $495 |
← Payers reporting HCPCS C5275 · Snapshot 20261111T120946Z-9134e7f7