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
HC Graftjacket Now 8x4cm Thick 32sqcm 86304x08 per Sq Cm
Low
$1
Average
$1.1k
Median
$88
High
$10.6k
Each hospital's average Medicaid rate, under the methodology and billing class chosen below.
49 hospitals; the 90th percentile is 152.5× 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.
Filter by billing methodology
Filter by billing class
58 hospital rates
iThe hospitals that file a Medicaid 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 | Allina Health Systems Ulm, MN facility · other · outpatient | 1 | $168 | $878 | $1.3k | 153% | — | $77 – $4.3k |
| 2 | Bullhead City Hospital Corporation City, AZ facility · percent of total billed charges · outpatientfrom % of charges | 1 | $105 | $105 | — | — | — | $105 – $105 |
| 3 | CATHOLIC HEALTH INITIATIVES COLORADO Salt Lake City, UT fee schedule · outpatient | 1 | $127 | $127 | — | — | — | $127 – $127 |
| 4 | CentraState Medical Center Freehold Township, NJ percent of total billed charges · bothfrom % of charges | 1 | $4.2k | $4.2k | — | — | — | $4.2k – $4.2k |
| 5 | Chapman Global Medical Center Orange, CA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $3.4k | $3.4k | $452 | 13% | — | $3.0k – $3.9k |
| 6 | Chilton Medical Center Pompton Plains, NJ percent of total billed charges · bothfrom % of charges | 1 | $2.0k | $2.0k | $292 | 15% | — | $1.7k – $2.3k |
| 7 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH CARMEL CARMEL, IN fee schedule · both | 2 | $56 | $56 | $5 | 9% | — | $51 – $61 |
| 8 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH CRAWFORDSVILLE CRAWFORDSVILLE, IN fee schedule · both | 1 | $51 | $51 | — | — | — | $51 – $51 |
| 9 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH CROWN POINT CROWN POINT, IN fee schedule · both | 14 | $51 | $53 | $4 | 8% | — | $51 – $61 |
| 10 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH DYER DYER, IN fee schedule · both | 14 | $51 | $53 | $4 | 8% | — | $51 – $61 |
| 11 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH INDIANAPOLIS INDIANAPOLIS, IN fee schedule · both | 16 | $51 | $53 | $4 | 8% | — | $51 – $61 |
| 12 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH LAFAYETTE LAFAYETTE, IN fee schedule · both | 2 | $56 | $56 | $5 | 9% | — | $51 – $61 |
| 13 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH MICHIGAN CITY CITY, IN fee schedule · both | 2 | $56 | $56 | $5 | 9% | — | $51 – $61 |
| 14 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH MICHIGAN CITY LAPORTE PORTE, IN fee schedule · both | 2 | $56 | $56 | $5 | 9% | — | $51 – $61 |
| 15 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH MOORESVILLE MOORESVILLE, IN fee schedule · both | 2 | $56 | $56 | $5 | 9% | — | $51 – $61 |
| 16 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH MUNSTER MUNSTER, IN fee schedule · both | 2 | $56 | $56 | $5 | 9% | — | $51 – $61 |
| 17 | FRANCISCAN HEALTH RENSSELAER, INC. RENSSELAER, IN fee schedule · both | 2 | $56 | $56 | $5 | 9% | — | $51 – $61 |
| 18 | Geisinger Community Medical Center Scranton, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 19 | Geisinger Lewistown Hospital Lewistown, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 20 | Geisinger Medical Center Muncy, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 21 | Geisinger Wyoming Valley Wilkes-Barre, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 22 | Grossmont Hospital Corporation La Mesa, CA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 23 | Grossmont Hospital Corporation La Mesa, CA percent of total billed charges · inpatientfrom % of charges | 1 | $170 | $170 | — | — | — | $170 – $170 |
| 24 | Grossmont Hospital Corporation La Mesa, CA percent of total billed charges · outpatientfrom % of charges | 1 | $176 | $176 | — | — | — | $176 – $176 |
| 25 | HealthAlliance - Clinton Hospital MA 01453; 201 Highland St Clinton, MA other · both | 1 | $151 | $151 | — | — | — | $151 – $151 |
← Payers reporting HCPCS Q4107 · Snapshot 20261111T120946Z-9134e7f7