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
TISSUE DERMAL MEMODERM (50SQ CM)5X10CM NON-MESHED EXTRA THICK 19800
Low
$109
Average
$1.1k
Median
$127
High
$11.2k
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
49 hospitals; the 90th percentile is 32.3× 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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50 hospital rates
iThe hospitals that file a Tricare 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 | CLAIBORNE MEDICAL CENTER Tazewell, TN fee schedule · outpatient | 1 | $121 | $121 | — | — | — | $121 – $121 |
| 2 | CUMBERLAND MEDICAL CENTER, INC. Crossville, TN fee schedule · outpatient | 1 | $121 | $121 | — | — | — | $121 – $121 |
| 3 | Canton-Potsdam Hospital Potsdam, NY facility · fee schedule · outpatient | 1 | $109 | $109 | — | — | — | $109 – $109 |
| 4 | Central Maine Medical Center Lewiston, ME fee schedule · outpatient | 1 | $127 | $127 | — | — | — | $127 – $127 |
| 5 | FORT LOUDOUN MEDICAL CENTER Lenoir City, TN fee schedule · outpatient | 1 | $113 | $113 | — | — | — | $113 – $113 |
| 6 | FORT SANDERS REGIONAL MEDICAL CENTER Knoxville, TN fee schedule · outpatient | 1 | $113 | $113 | — | — | — | $113 – $113 |
| 7 | Granbury Hospital Corporation Granbury, TX facility · fee schedule · outpatient | 1 | $127 | $127 | — | — | — | $127 – $127 |
| 8 | Hemet Global Medical Center Hemet, CA facility · fee schedule · outpatient | 1 | $127 | $127 | — | — | — | $127 – $127 |
| 9 | Hemet Global Medical Center Hemet, CA professional · fee schedule · outpatient | 1 | $101 | $101 | — | — | — | $101 – $101 |
| 10 | Hospital Authority of Colquitt County Moultrie, GA fee schedule · both | 1 | $8.6k | $11.2k | $8.8k | 79% | — | $291 – $26.2k |
| 11 | KAPLAN GENERAL HOSPITAL, INC ST, LA percent of total billed charges · outpatientfrom % of charges | 1 | $5.5k | $5.5k | — | — | — | $5.5k – $5.5k |
| 12 | Kaleida Health Buffalo, NY fee schedule · outpatient | 1 | $148 | $148 | — | — | — | $148 – $148 |
| 13 | LECONTE MEDICAL CENTER Sevierville, TN fee schedule · outpatient | 1 | $121 | $121 | — | — | — | $121 – $121 |
| 14 | Laredo Texas Hospital Company LP Laredo, TX facility · fee schedule · outpatient | 1 | $127 | $127 | — | — | — | $127 – $127 |
| 15 | Las Cruces Medical Center LLC Las Cruces, NM facility · fee schedule · outpatient | 1 | $127 | $127 | — | — | — | $127 – $127 |
| 16 | MCLAREN CARO REGION CARO, MI fee schedule | 1 | $284 | $284 | — | — | — | $284 – $284 |
| 17 | MCLAREN THUMB REGION AXE, MI fee schedule | 1 | $182 | $182 | — | — | — | $182 – $182 |
| 18 | METHODIST MEDICAL CENTER OF OAK RIDGE Oak Ridge, TN fee schedule · outpatient | 1 | $113 | $113 | — | — | — | $113 – $113 |
| 19 | MORRISTOWN HAMBLEN HOSPITAL ASSOCIATION Morristown, TN fee schedule · outpatient | 1 | $113 | $113 | — | — | — | $113 – $113 |
| 20 | MedStar Franklin Square Medical Center Baltimore, MD percent of total billed charges · outpatientfrom % of charges | 1 | $3.4k | $3.4k | $754 | 22% | — | $2.7k – $4.2k |
| 21 | MedStar Georgetown Hospital Washington, DC facility · fee schedule · outpatient | 1 | $147 | $147 | — | — | — | $147 – $147 |
| 22 | MedStar Good Samaritan Hospital Baltimore, MD percent of total billed charges · outpatientfrom % of charges | 1 | $4.1k | $4.1k | $863 | 21% | — | $3.2k – $4.9k |
| 23 | MedStar Harbor Hospital Baltimore, MD percent of total billed charges · outpatientfrom % of charges | 1 | $3.2k | $3.2k | $773 | 24% | — | $2.4k – $4.0k |
| 24 | MedStar Montgomery Medical Center Olney, MD percent of total billed charges · outpatientfrom % of charges | 1 | $3.5k | $3.5k | $878 | 25% | — | $2.7k – $4.4k |
| 25 | MedStar Southern Hospital Center Clinton, MD percent of total billed charges · outpatientfrom % of charges | 1 | $5.0k | $5.0k | $1.3k | 26% | — | $3.7k – $6.3k |
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