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
GRAFT SOFT TISSUE 16X10CM TUTOPATCH BOVINE PERICARDIUM STERILE LATEX FREE
Low
$0
Average
$3.8k
Median
$3.3k
High
$15.6k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
59 payers; the 90th percentile is 10.4× the 10th. Each bar is a price range and its height is how many payers fall in it. Hover a bar, or a row in the ladder, for details.
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| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Bcbs Nc percent of total billed charges · outpatientfrom % of charges · +2 other terms | 12 | $334 | $419 | $304 | 73% | 21–210 | $64 – $1.6k |
| 2 | UnitedHealthcare fee schedule · outpatient · +18 other terms | 105 | $3.4k | $4.5k | $6.4k | 143% | — | $0 – $59.7k |
| 3 | MultiPlan fee schedule · outpatient · +12 other terms | 80 | $6.5k | $9.3k | $12.3k | 132% | — | $0 – $84.7k |
| 4 | Cigna fee schedule · outpatient · +21 other terms | 62 | $6.3k | $6.8k | $8.0k | 118% | — | $1 – $72.3k |
| 5 | Aetna fee schedule · outpatient · +20 other terms | 59 | $974 | $4.1k | $5.4k | 132% | — | $0 – $50.5k |
| 6 | Blue Cross Blue Shield fee schedule · outpatient · +25 other terms | 44 | $3.0k | $3.2k | $5.6k | 176% | — | $0 – $55.4k |
| 7 | Medcost percent of total billed charges · bothfrom % of charges · +5 other terms | 41 | $62 | $44 | $477 | 1081% | — | $0 – $13.6k |
| 8 | Anthem fee schedule · outpatient · +18 other terms | 38 | $4.0k | $5.3k | $7.8k | 148% | — | $14 – $42.4k |
| 9 | Humana fee schedule · outpatient · +14 other terms | 35 | $2.0k | $4.0k | $7.8k | 194% | — | $0 – $46.7k |
| 10 | First Health fee schedule · outpatient · +10 other terms | 33 | $7.3k | $8.3k | $9.8k | 117% | — | $64 – $54.5k |
| 11 | Kaiser fee schedule · outpatient · +11 other terms | 30 | $5.8k | $5.5k | $6.6k | 120% | — | $1 – $51.7k |
| 12 | Molina fee schedule · outpatient · +14 other terms | 27 | $2.5k | $3.0k | $3.6k | 119% | — | $1 – $21.9k |
| 13 | Amerihealth Caritas other · outpatient · +6 other terms | 25 | $1.6k | $1.8k | $2.1k | 118% | — | $52 – $16.0k |
| 14 | Superior Healthplan percent of total billed charges · outpatientfrom % of charges | 25 | $143 | $636 | $1.1k | 173% | — | $1 – $4.5k |
| 15 | Phcs fee schedule · inpatient · +10 other terms | 22 | $4.7k | $7.3k | $11.6k | 158% | — | $0 – $65.0k |
| 16 | Aetna Better Health other · outpatient · +4 other terms | 19 | $1.2k | $1.6k | $1.9k | 114% | — | $52 – $16.0k |
| 17 | Ambetter other · outpatient · +10 other terms | 19 | $8.3k | $52.8k | $62.9k | 119% | — | $236 – $185.3k |
| 18 | Medica fee schedule · outpatient · +9 other terms | 19 | $3.6k | $3.8k | $3.3k | 87% | — | $0 – $13.0k |
| 19 | Beechstreet percent of total billed charges · outpatientfrom % of charges · +2 other terms | 17 | $1.2k | $1.2k | $725 | 60% | — | $126 – $2.6k |
| 20 | Caresource fee schedule · outpatient · +10 other terms | 17 | $317 | $318 | $354 | 111% | — | $1 – $9.1k |
| 21 | Bcbs Az facility · fee schedule · outpatient · +1 other terms | 15 | $969 | $1.0k | $202 | 20% | — | $362 – $1.3k |
| 22 | Healthcare Highways percent of total billed charges · outpatientfrom % of charges · +1 other terms | 15 | $1.8k | $3.3k | $5.2k | 156% | — | $13 – $21.7k |
| 23 | Medicaid fee schedule · outpatient · +9 other terms | 15 | $34 | $4.3k | $8.5k | 199% | — | $0 – $35.0k |
| 24 | WellCare other · outpatient · +9 other terms | 13 | $4.2k | $3.5k | $2.6k | 75% | — | $59 – $9.3k |
| 25 | Bcbs Nj percent of total billed charges · outpatientfrom % of charges | 12 | $7.4k | $7.8k | $2.1k | 27% | — | $3.2k – $12.3k |
← Hospitals reporting HCPCS Q4100 · Snapshot 20261111T120946Z-9134e7f7