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
$16
Average
$2.2k
Median
$867
High
$15.8k
Each hospital's average Healthpartners rate, under the methodology and billing class chosen below.
18 hospitals; the 90th percentile is 297.0× 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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25 hospital rates
iThe hospitals that file a Healthpartners 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 | Aurora Medical Center Grafton Grafton, WI percent of total billed charges · inpatientfrom % of charges | 1 | $156 | $156 | — | — | — | $156 – $156 |
| 2 | Aurora Medical Center Grafton Grafton, WI percent of total billed charges · outpatientfrom % of charges | 3 | $156 | $146 | $15 | 10% | — | $125 – $156 |
| 3 | Aurora Medical Center Kenosha Kenosha, WI percent of total billed charges · inpatientfrom % of charges | 1 | $132 | $132 | — | — | — | $132 – $132 |
| 4 | Aurora Medical Center Kenosha Kenosha, WI percent of total billed charges · outpatientfrom % of charges | 3 | $132 | $124 | $12 | 10% | — | $106 – $132 |
| 5 | Aurora Medical Center Sheboygan County Sheboygan, WI percent of total billed charges · inpatientfrom % of charges | 1 | $107 | $107 | — | — | — | $107 – $107 |
| 6 | Aurora Medical Center Sheboygan County Sheboygan, WI percent of total billed charges · outpatientfrom % of charges | 3 | $107 | $100 | $10 | 10% | — | $86 – $107 |
| 7 | Aurora Medical Center Washington County Hartford, WI percent of total billed charges · inpatientfrom % of charges | 1 | $425 | $425 | — | — | — | $425 – $425 |
| 8 | Aurora Medical Center Washington County Hartford, WI percent of total billed charges · outpatientfrom % of charges | 3 | $425 | $396 | $40 | 10% | — | $340 – $425 |
| 9 | Aurora St Lukes Medical Center of Aurora Health Care Metro Inc Milwaukee, WI percent of total billed charges · inpatientfrom % of charges | 1 | $184 | $184 | — | — | — | $184 – $184 |
| 10 | Aurora St Lukes Medical Center of Aurora Health Care Metro Inc Milwaukee, WI percent of total billed charges · outpatientfrom % of charges | 3 | $184 | $171 | $17 | 10% | — | $147 – $184 |
| 11 | BSA Hospital Amarillo, TX facility · percent of total billed charges · bothfrom % of charges | 1 | $13.3k | $15.8k | $10.9k | 69% | — | $2.7k – $29.0k |
| 12 | Essentia Health Duluth Duluth, MN facility · percent of total billed charges · outpatientfrom % of charges | 3 | $19 | $17 | $4 | 22% | — | $11 – $19 |
| 13 | Essentia Health Fargo 3000 32nd Ave S Fargo, ND facility · percent of total billed charges · outpatientfrom % of charges | 2 | $239 | $607 | $729 | 120% | — | $11 – $2.0k |
| 14 | Essentia Health St. Mary's Children's Hospital Duluth, MN facility · percent of total billed charges · outpatientfrom % of charges | 3 | $18 | $16 | $4 | 21% | — | $11 – $19 |
| 15 | Essentia Health St. Mary's Medical Center Duluth, MN facility · percent of total billed charges · outpatientfrom % of charges | 3 | $18 | $16 | $4 | 21% | — | $11 – $19 |
| 16 | Mayo Clinic Rochester, MN facility · percent of total billed charges · bothfrom % of charges | 5 | $1.2k | $3.6k | $5.9k | 163% | — | $59 – $23.3k |
| 17 | Mayo Clinic Arizona Phoenix, AZ facility · percent of total billed charges · bothfrom % of charges | 2 | $783 | $1.4k | $1.3k | 98% | — | $272 – $4.3k |
| 18 | Mayo Clinic Florida Jacksonville, FL facility · percent of total billed charges · bothfrom % of charges | 2 | $849 | $2.4k | $4.0k | 167% | — | $237 – $15.2k |
| 19 | Mayo Clinic Health System Sparta, WI facility · percent of total billed charges · bothfrom % of charges | 2 | $615 | $1.4k | $1.1k | 78% | — | $615 – $2.9k |
| 20 | Northfield Hospital Northfield, MN percent of total billed charges · bothfrom % of charges | 1 | $2.6k | $2.6k | — | — | — | $2.6k – $2.6k |
| 21 | University of Iowa Health Care Medical Center Iowa City, IA facility · percent of total billed charges · inpatientfrom % of charges | 3 | $5.5k | $5.1k | $4.1k | 81% | — | $3 – $14.0k |
| 22 | University of Iowa Health Care Medical Center Iowa City, IA facility · percent of total billed charges · outpatientfrom % of charges | 3 | $5.5k | $5.0k | $4.0k | 80% | — | $3 – $13.5k |
| 23 | University of Iowa Health Care Medical Center Downtown Iowa City, IA facility · percent of total billed charges · inpatientfrom % of charges | 3 | $5.5k | $5.1k | $4.1k | 81% | — | $3 – $14.0k |
| 24 | University of Iowa Health Care Medical Center Downtown Iowa City, IA facility · percent of total billed charges · outpatientfrom % of charges | 3 | $5.5k | $5.0k | $4.0k | 80% | — | $3 – $13.5k |
| 25 | Westfields Hospital New Richmond, WI facility · percent of total billed charges · bothfrom % of charges | 1 | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
← Payers reporting HCPCS Q4100 · Snapshot 20261111T120946Z-9134e7f7