Dermagraft skin substitute

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

GRAFT, DERMAGRAFT SKIN

Medicaid pricing summary

Low

Average

$416

Median

$41

High

$5.4k

Medicaid rate distribution

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27 hospital rates

#		Plans
1	CentraState Medical Center Freehold Township, NJ percent of total billed charges · bothfrom % of charges	1	$1.8k	$1.8k	—	—	—	$1.8k – $1.8k
2	FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH CARMEL CARMEL, IN fee schedule · both	2	$41	$41	$4	9%	—	$38 – $45
3	FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH CRAWFORDSVILLE CRAWFORDSVILLE, IN fee schedule · both	1	$38	$38	—	—	—	$38 – $38
4	FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH CROWN POINT CROWN POINT, IN fee schedule · both	14	$38	$39	$3	8%	—	$38 – $45
5	FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH DYER DYER, IN fee schedule · both	14	$38	$39	$3	8%	—	$38 – $45
6	FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH INDIANAPOLIS INDIANAPOLIS, IN fee schedule · both	16	$38	$39	$3	8%	—	$38 – $45
7	FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH LAFAYETTE LAFAYETTE, IN fee schedule · both	2	$41	$41	$4	9%	—	$38 – $45
8	FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH MICHIGAN CITY CITY, IN fee schedule · both	2	$41	$41	$4	9%	—	$38 – $45
9	FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH MICHIGAN CITY LAPORTE PORTE, IN fee schedule · both	2	$41	$41	$4	9%	—	$38 – $45
10	FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH MOORESVILLE MOORESVILLE, IN fee schedule · both	2	$41	$41	$4	9%	—	$38 – $45
11	FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH MUNSTER MUNSTER, IN fee schedule · both	2	$41	$41	$4	9%	—	$38 – $45
12	FRANCISCAN HEALTH RENSSELAER, INC. RENSSELAER, IN fee schedule · both	2	$41	$41	$4	9%	—	$38 – $45
13	Hospital Authority of Colquitt County Moultrie, GA fee schedule · both	1	$5.4k	$5.4k	$160	3%	—	$5.3k – $5.6k
14	Hospital Service District #1, Parish of Terrebonne, State of Louisiana dba Terrebonne General Health System Houma, LA facility · other · outpatient	1	$10	$10	—	—	—	$10 – $10
15	Lake Charles Memorial Hospital Charles., LA percent of total billed charges · outpatientfrom % of charges	1	$15	$15	—	—	—	$15 – $15
16	Lowell General Hospital Lowell, MA percent of total billed charges · bothfrom % of charges	1	$2.5k	$2.5k	—	—	—	$2.5k – $2.5k
17	McLeod Health Dillon, SC fee schedule · both	1	$83	$83	—	—	—	$83 – $83
18	McLeod Health Cheraw, SC fee schedule · both	1	$83	$83	—	—	—	$83 – $83
19	McLeod Health Manning, SC fee schedule · both	1	$83	$83	—	—	—	$83 – $83
20	McLeod Health Florence, SC fee schedule · both	1	$83	$83	—	—	—	$83 – $83
21	McLeod Health Beach, SC fee schedule · both	1	$83	$83	—	—	—	$83 – $83
22	McLeod Health Loris, SC fee schedule · both	1	$83	$83	—	—	—	$83 – $83
23	McLeod Health River, SC fee schedule · both	1	$83	$83	—	—	—	$83 – $83
24	Ohio State University Hospitals Columbus, OH fee schedule · outpatient	1	$1	$1	—	—	—	$1 – $1
25	Stephens County Hospital Toccoa, GA percent of total billed charges · outpatientfrom % of charges	1	$51	$51	—	—	—	$51 – $51

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HCPCS Q4106