Artiss fibrin sealant

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.

Generation details were not recorded for this description.

Original text from hospital filings

DEVICE HEMOSTATIC SYSTEM FIBRIN SEALANT STANDARD SYRINGE FROZEN STERILE DISPOSABLE PRIMA 2ML

Wellmark pricing summary

Low

$136

Average

$289

Median

$212

High

$978

Wellmark rate distribution

Filter by billing methodology

Filter by billing class

34 hospital rates

#		Plans
1	Pella Regional Health Center Pella, IA other · outpatient	2	$978	$978	$193	20%	4–40	$785 – $1.2k
2	ALEGENT HEALTH - MERCY HOSPITAL, CORNING IOWA Corning, IA fee schedule · inpatient	2	$1.3k	$1.3k	$506	38%	—	$810 – $1.8k
3	ALEGENT HEALTH - MERCY HOSPITAL, CORNING IOWA Corning, IA fee schedule · outpatient	2	$227	$227	—	—	—	$227 – $227
4	ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM Council Bluffs, IA fee schedule · outpatient	2	$227	$227	—	—	—	$227 – $227
5	ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA Missouri Valley, IA fee schedule · inpatient	2	$1.3k	$1.3k	$481	38%	—	$770 – $1.7k
6	ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA Missouri Valley, IA fee schedule · outpatient	2	$227	$227	—	—	—	$227 – $227
7	Allen Memorial Hospital Corporation Waterloo, IA case rate · outpatient	1	$145	$145	—	—	—	$145 – $145
8	Allen Memorial Hospital Corporation Waterloo, IA fee schedule · outpatient	3	$234	$234	—	—	—	$234 – $234
9	Central Iowa Hospital Corporation Des Moines, IA case rate · outpatient	1	$145	$145	—	—	—	$145 – $145
10	Central Iowa Hospital Corporation Des Moines, IA fee schedule · outpatient	3	$234	$234	—	—	—	$234 – $234
11	Central Iowa Hospital Corporation West Des Moines, IA fee schedule · outpatient	3	$234	$234	—	—	—	$234 – $234
12	Grinnell Regional Medical Center Grinnell, IA case rate · outpatient	1	$145	$145	—	—	—	$145 – $145
13	Grinnell Regional Medical Center Grinnell, IA fee schedule · outpatient	3	$234	$234	—	—	—	$234 – $234
14	MercyOne Genesis Davenport Medical Center IA 52803; 2140 53rd Avenue Bettendorf, IA facility · fee schedule · outpatient	1	$136	$136	—	—	—	$136 – $136
15	MercyOne Genesis Davenport West Medical Center Davenport, IA facility · fee schedule · outpatient	1	$142	$142	—	—	—	$142 – $142
16	MercyOne Genesis Silvis Medical Center Silvis, IL facility · fee schedule · outpatient	1	$148	$148	—	—	—	$148 – $148
17	Meriter Hospital, Inc Madison, WI case rate · outpatient	1	$142	$142	—	—	—	$142 – $142
18	Northwest Iowa Hospital Corporation Sioux City, IA case rate · outpatient	1	$145	$145	—	—	—	$145 – $145
19	Northwest Iowa Hospital Corporation Sioux City, IA fee schedule · outpatient	3	$234	$234	—	—	—	$234 – $234
20	St Luke's Methodist Hospital Marion, IA case rate · outpatient	1	$145	$145	—	—	—	$145 – $145
21	St Luke's Methodist Hospital Marion, IA fee schedule · outpatient	3	$234	$234	—	—	—	$234 – $234
22	The Finley Hospital Dubuque, IA case rate · outpatient	1	$145	$145	—	—	—	$145 – $145
23	The Finley Hospital Dubuque, IA fee schedule · outpatient	3	$234	$234	—	—	—	$234 – $234
24	Trinity Medical Center Rock Island, IL case rate · outpatient	1	$145	$145	—	—	—	$145 – $145
25	Trinity Medical Center Rock Island, IL fee schedule · outpatient	1	$234	$234	—	—	—	$234 – $234

Page 1 of 2

← Payers reporting HCPCS C9250 · Snapshot 20261111T120946Z-9134e7f7

HCPCS C9250