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
OASIS BURN MATRIX, PER SQUARE CENTIMETER
Low
$1
Average
$98
Median
$71
High
$254
Each hospital's average Caresource rate, under the methodology and billing class chosen below.
134 hospitals; the 90th percentile is 16.9× 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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139 hospital rates
iThe hospitals that file a Caresource 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 | Adena Fayette Medical Center Washington Court House, OH facility · case rate · outpatient | 1 | $254 | $254 | — | — | — | $254 – $254 |
| 2 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 2 | $179 | $179 | $58 | 32% | — | $121 – $238 |
| 3 | Bay Park Community Hospital Oregon, OH facility · fee schedule · outpatient | 2 | $42 | $42 | $19 | 45% | — | $23 – $61 |
| 4 | Bay Park Community Hospital Oregon, OH professional · fee schedule · outpatient | 2 | $12 | $12 | $7 | 62% | — | $4 – $19 |
| 5 | Beavercreek Medical Center Springfield, OH fee schedule · outpatient | 1 | $190 | $190 | — | — | — | $190 – $190 |
| 6 | Berger Hospital Circleville, OH fee schedule · outpatient | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 7 | CHI MEMORIAL HOSPITAL - GEORGIA Ringgold, GA fee schedule · outpatient | 1 | $12 | $12 | — | — | — | $12 – $12 |
| 8 | Camden-Clark Memorial Hospital Corporation Parkersburg, WV facility · other · outpatient | 2 | $161 | $161 | $28 | 18% | — | $133 – $190 |
| 9 | City Hospital, Inc. Martinsburg, WV facility · other · outpatient | 1 | $190 | $190 | — | — | — | $190 – $190 |
| 10 | Clinton Memorial Hospital Wilmington, OH fee schedule · outpatient | 1 | $156 | $156 | — | — | — | $156 – $156 |
| 11 | Dayton Osteopathic Hospital Dayton, OH fee schedule · outpatient | 1 | $190 | $190 | — | — | — | $190 – $190 |
| 12 | Deaconess Hospital, Inc Newburgh, IN facility · case rate · outpatient | 1 | $49 | $49 | — | — | — | $49 – $49 |
| 13 | Defiance Hospital Inc Defiance, OH facility · fee schedule · outpatient | 2 | $18 | $18 | $5 | 29% | — | $13 – $23 |
| 14 | Defiance Hospital Inc Defiance, OH professional · fee schedule · outpatient | 2 | $12 | $12 | $7 | 62% | — | $4 – $19 |
| 15 | Diley Ridge Medical Center Canal Winchester, OH facility · percent of total billed charges · bothfrom % of charges | 1 | $183 | $183 | — | — | — | $183 – $183 |
| 16 | Doctors Hospital Columbus, OH fee schedule · outpatient | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 17 | Dublin Methodist Hospital Dublin, OH fee schedule · outpatient | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 18 | FAIRVIEW PARK HOSPITAL DUBLIN, GA fee schedule · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 19 | Fort Hamilton Hospital Hamilton, OH fee schedule · outpatient | 1 | $191 | $191 | — | — | — | $191 – $191 |
| 20 | Fostoria Hospital Association Fostoria, OH facility · fee schedule · outpatient | 2 | $18 | $18 | $5 | 29% | — | $13 – $23 |
| 21 | Fostoria Hospital Association Fostoria, OH professional · fee schedule · outpatient | 2 | $12 | $12 | $7 | 62% | — | $4 – $19 |
| 22 | Grady Memorial Hospital Atlanta, GA professional · fee schedule · outpatient | 2 | $15 | $15 | $5 | 30% | — | $11 – $20 |
| 23 | Grady Memorial Hospital Delaware, OH fee schedule · outpatient | 2 | $71 | $71 | $50 | 70% | — | $21 – $121 |
| 24 | Grant Medical Center Columbus, OH fee schedule · outpatient | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 25 | Greene Memorial Hospital Inc Xenia, OH fee schedule · outpatient | 1 | $188 | $188 | — | — | — | $188 – $188 |
← Payers reporting HCPCS Q4103 · Snapshot 20261111T120946Z-9134e7f7