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 DERMAL 0.8 TO 1.7MMX8 20CM PLIABLE FOLDING HYDRATED THICK FLEXHD ACELLULAR DERMIS IMPLANTABLE
Low
$0
Average
$2.5k
Median
$198
High
$56.8k
Each hospital's average Blue Cross Blue Shield rate, under the methodology and billing class chosen below.
734 hospitals; the 90th percentile is 212.2× 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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959 hospital rates
iThe hospitals that file a Blue Cross Blue Shield 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 | Piedmont Augusta Augusta, GA percent of total billed charges · bothfrom % of charges | 2 | $23.4k | $14.5k | $10.4k | 72% | 1,208–1,388 | $211 – $24.3k |
| 2 | DIGNITY HEALTH Phoenix, AZ fee schedule · outpatient | 4 | $195 | $222 | $66 | 30% | 40–400 | $167 – $329 |
| 3 | Self Regional Healthcare Greenwood, SC facility · other · outpatient | 1 | $56.8k | $56.8k | — | — | 39–390 | $56.8k – $56.8k |
| 4 | DIGNITY COMMUNITY CARE Chandler, AZ fee schedule · outpatient | 4 | $144 | $164 | $50 | 30% | 13–130 | $124 – $245 |
| 5 | ROBERT PACKER HOSPITAL Sayre, PA facility · other · outpatient | 2 | $13.0k | $13.0k | $4.3k | 33% | 4–40 | $8.6k – $17.3k |
| 6 | Public Hospital District No 1 of Mason County Shelton, WA fee schedule · both | 1 | $2.2k | $2.2k | — | — | 3–30 | $2.2k – $2.2k |
| 7 | Mayo Clinic Arizona Phoenix, AZ facility · percent of total billed charges · bothfrom % of charges | 5 | $29.3k | $31.2k | $3.9k | 13% | 2–20 | $29.3k – $39k |
| 8 | Novant Health Ballantyne Medical Center LLC Charlotte, NC percent of total billed charges · outpatientfrom % of charges | 2 | $22.4k | $22.4k | — | — | 2–20 | $22.4k – $22.4k |
| 9 | Novant Health Matthews Medical Center LLC Matthews, NC percent of total billed charges · outpatientfrom % of charges | 2 | $44.8k | $44.8k | — | — | 2–20 | $44.8k – $44.8k |
| 10 | The Presbyterian Hospital Charlotte, NC percent of total billed charges · outpatientfrom % of charges | 2 | $53.8k | $53.8k | — | — | 2–20 | $53.8k – $53.8k |
| 11 | West Virginia University Hospitals, Inc. Morgantown, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $5.2k | $5.2k | — | — | 2–20 | $5.2k – $5.2k |
| 12 | Hillsdale Hospital Hillsdale, MI percent of total billed charges · bothfrom % of charges | 1 | $2.8k | $2.8k | — | — | 1–10 | $2.8k – $2.8k |
| 13 | ADVENTIST HEALTH DELANO Delano, CA other · outpatient | 2 | $1.3k | $1.3k | $1.2k | 89% | — | $139 – $2.5k |
| 14 | ADVENTIST HEALTH DELANO Delano, CA percent of total billed charges · outpatientfrom % of charges | 1 | $494 | $494 | $0 | 0% | — | $493 – $494 |
| 15 | ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI Tehachapi, CA case rate · outpatient | 2 | $1.1k | $1.1k | $56 | 5% | — | $1.0k – $1.1k |
| 16 | ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI Tehachapi, CA percent of total billed charges · outpatientfrom % of charges | 3 | $953 | $836 | $297 | 36% | — | $428 – $1.1k |
| 17 | AGH LAVEEN LLC Phoenix, AZ fee schedule · outpatient | 3 | $73 | $81 | $11 | 14% | — | $73 – $98 |
| 18 | AGH MESA LLC Mesa, AZ fee schedule · outpatient | 3 | $73 | $81 | $11 | 14% | — | $73 – $98 |
| 19 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY facility · case rate · outpatient | 4 | $1.7k | $2.2k | $810 | 37% | — | $1.4k – $3.2k |
| 20 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY facility · percent of total billed charges · bothfrom % of charges | 3 | $1.6k | $2.6k | $2.9k | 111% | — | $98 – $9.5k |
| 21 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY facility · percent of total billed charges · inpatientfrom % of charges | 3 | $1.6k | $2.6k | $2.9k | 111% | — | $98 – $9.2k |
| 22 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY facility · percent of total billed charges · outpatientfrom % of charges | 3 | $1.6k | $2.6k | $2.9k | 111% | — | $98 – $9.1k |
| 23 | ALEGENT CREIGHTON HEALTH Papillion, NE fee schedule · outpatient | 2 | $31 | $31 | $4 | 14% | — | $26 – $35 |
| 24 | ALEGENT CREIGHTON HEALTH Omaha, NE fee schedule · outpatient | 2 | $31 | $31 | $4 | 14% | — | $26 – $35 |
| 25 | ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM Council Bluffs, IA fee schedule · outpatient | 2 | $31 | $31 | $4 | 14% | — | $26 – $35 |
← Payers reporting HCPCS Q4128 · Snapshot 20261111T120946Z-9134e7f7