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
$348
Average
$1.2k
Median
$506
High
$3.6k
Each hospital's average Ucare rate, under the methodology and billing class chosen below.
19 hospitals; the 90th percentile is 9.8× 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 Ucare 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 | Mayo Clinic Rochester, MN facility · percent of total billed charges · bothfrom % of charges | 4 | $886 | $3.2k | $5.5k | 172% | 8–80 | $59 – $22.2k |
| 2 | Essentia Health Duluth Duluth, MN facility · percent of total billed charges · inpatientfrom % of charges | 1 | $19 | $4.8k | $6.7k | 141% | — | $18 – $14.2k |
| 3 | Essentia Health Duluth Duluth, MN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 4 | Essentia Health Fargo 3000 32nd Ave S Fargo, ND facility · percent of total billed charges · inpatientfrom % of charges | 1 | $22 | $257 | $336 | 131% | — | $18 – $732 |
| 5 | Essentia Health Fargo 3000 32nd Ave S Fargo, ND facility · percent of total billed charges · outpatientfrom % of charges | 1 | $388 | $693 | $796 | 115% | — | $18 – $2.0k |
| 6 | Essentia Health St. Mary's Children's Hospital Duluth, MN facility · percent of total billed charges · inpatientfrom % of charges | 1 | $19 | $4.8k | $6.7k | 141% | — | $18 – $14.2k |
| 7 | Essentia Health St. Mary's Children's Hospital Duluth, MN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 8 | Essentia Health St. Mary's Medical Center Duluth, MN facility · percent of total billed charges · inpatientfrom % of charges | 1 | $19 | $4.8k | $6.7k | 141% | — | $18 – $14.2k |
| 9 | Essentia Health St. Mary's Medical Center Duluth, MN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 10 | Fairview Bethesda Hospital St. Paul, MN percent of total billed charges · inpatientfrom % of charges | 1 | $308 | $308 | $129 | 42% | — | $179 – $437 |
| 11 | Fairview Bethesda Hospital St. Paul, MN percent of total billed charges · outpatientfrom % of charges | 2 | $368 | $368 | $154 | 42% | — | $214 – $522 |
| 12 | Fairview Health Services Edina, MN percent of total billed charges · outpatientfrom % of charges | 2 | $368 | $368 | $154 | 42% | — | $214 – $522 |
| 13 | Fairview Health Services Minneapolis, MN percent of total billed charges · outpatientfrom % of charges | 4 | $316 | $349 | $150 | 43% | — | $171 – $522 |
| 14 | Fairview Health Services Burnsville, MN percent of total billed charges · outpatientfrom % of charges | 2 | $368 | $368 | $154 | 42% | — | $214 – $522 |
| 15 | Fairview Health Services Wyoming, MN percent of total billed charges · outpatientfrom % of charges | 2 | $368 | $368 | $154 | 42% | — | $214 – $522 |
| 16 | Fairview Health Services Princeton, MN percent of total billed charges · outpatientfrom % of charges | 2 | $368 | $368 | $154 | 42% | — | $214 – $522 |
| 17 | GILLETTE CHILDREN'S SPECIALTY HEALTHCARE PAUL, MN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $398 | $398 | — | — | — | $398 – $398 |
| 18 | HealthEast St John's Hospital Maplewood, MN percent of total billed charges · outpatientfrom % of charges | 2 | $368 | $368 | $154 | 42% | — | $214 – $522 |
| 19 | HealthEast Woodwinds Hospital Woodbury, MN percent of total billed charges · outpatientfrom % of charges | 2 | $368 | $368 | $154 | 42% | — | $214 – $522 |
| 20 | Mayo Clinic Health System Sparta, WI facility · percent of total billed charges · bothfrom % of charges | 3 | $714 | $1.3k | $914 | 70% | — | $615 – $2.6k |
| 21 | ST. JOSEPH'S AREA HEALTH SERVICES Park Rapids, MN fee schedule · inpatient | 1 | $989 | $989 | — | — | — | $989 – $989 |
| 22 | ST. JOSEPH'S AREA HEALTH SERVICES Park Rapids, MN fee schedule · outpatient | 3 | $433 | $608 | $270 | 44% | — | $401 – $989 |
| 23 | Saint Alphonsus Medical Center - Baker City Baker City, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $1.6k | $1.4k | $1.1k | 75% | — | $50 – $2.7k |
| 24 | Saint Alphonsus Medical Center - Ontario Ontario, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $1.1k | $985 | $736 | 75% | — | $34 – $1.8k |
| 25 | Westfields Hospital New Richmond, WI facility · percent of total billed charges · bothfrom % of charges | 1 | $634 | $634 | — | — | — | $634 – $634 |
← Payers reporting HCPCS Q4100 · Snapshot 20261111T120946Z-9134e7f7