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
$29
Average
$2.3k
Median
$127
High
$20.2k
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
89 hospitals; the 90th percentile is 336.1× 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
91 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 | Armstrong County Memorial Hospital Kittanning, PA facility · fee schedule · outpatient | 1 | $127 | $127 | — | — | — | $127 – $127 |
| 2 | CLAIBORNE MEDICAL CENTER Tazewell, TN fee schedule · outpatient | 1 | $121 | $121 | — | — | — | $121 – $121 |
| 3 | CORNING HOSPITAL Corning, NY facility · other · outpatient | 1 | $10.9k | $10.9k | $885 | 8% | — | $10.0k – $11.7k |
| 4 | CUMBERLAND MEDICAL CENTER, INC. Crossville, TN fee schedule · outpatient | 1 | $121 | $121 | — | — | — | $121 – $121 |
| 5 | Campbell County HMA, LLC LaFollette, TN facility · fee schedule · outpatient | 1 | $127 | $127 | — | — | — | $127 – $127 |
| 6 | Canton-Potsdam Hospital Potsdam, NY facility · fee schedule · outpatient | 1 | $109 | $109 | — | — | — | $109 – $109 |
| 7 | CentraState Medical Center Freehold Township, NJ other · outpatient | 2 | $20.2k | $20.2k | — | — | — | $20.2k – $20.2k |
| 8 | Central Maine Medical Center Lewiston, ME fee schedule · outpatient | 1 | $127 | $127 | — | — | — | $127 – $127 |
| 9 | Charleston Area Medical Center Charleston, WV percent of total billed charges · bothfrom % of charges | 1 | $9.9k | $9.9k | — | — | — | $9.9k – $9.9k |
| 10 | Chilton Medical Center Pompton Plains, NJ other · outpatient | 2 | $20.2k | $20.2k | — | — | — | $20.2k – $20.2k |
| 11 | Cocke County HMA, LLC Newport, TN facility · fee schedule · outpatient | 1 | $127 | $127 | — | — | — | $127 – $127 |
| 12 | Conway Regional Medical Center Conway, AR facility · fee schedule · outpatient | 1 | $16.2k | $17.1k | $3.4k | 20% | — | $13.5k – $21.6k |
| 13 | Doylestown Hospital Doylestown, PA facility · fee schedule · outpatient | 1 | $127 | $127 | — | — | — | $127 – $127 |
| 14 | Ellis Hospital NY 12308; 2210 Troy Schenectady Road Niskayuna, NY facility · fee schedule · outpatient | 1 | $127 | $629 | $1.4k | 226% | — | $127 – $5.4k |
| 15 | FORT LOUDOUN MEDICAL CENTER Lenoir City, TN fee schedule · outpatient | 1 | $113 | $113 | — | — | — | $113 – $113 |
| 16 | FORT SANDERS REGIONAL MEDICAL CENTER Knoxville, TN fee schedule · outpatient | 1 | $113 | $113 | — | — | — | $113 – $113 |
| 17 | GUTHRIE CORTLAND MEDICAL CENTER Cortland, NY facility · other · outpatient | 1 | $71 | $71 | — | — | — | $71 – $71 |
| 18 | Granbury Hospital Corporation Granbury, TX facility · fee schedule · outpatient | 1 | $127 | $127 | — | — | — | $127 – $127 |
| 19 | HSA PGH LLC Hialeah, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $127 | $127 | — | — | — | $127 – $127 |
| 20 | Hackettstown Medical Center Hackettstown, NJ other · outpatient | 2 | $2.0k | $2.0k | — | — | — | $2.0k – $2.0k |
| 21 | Hemet Global Medical Center Hemet, CA facility · fee schedule · outpatient | 1 | $127 | $127 | — | — | — | $127 – $127 |
| 22 | Hemet Global Medical Center Hemet, CA professional · fee schedule · outpatient | 1 | $119 | $119 | — | — | — | $119 – $119 |
| 23 | Holy Cross Germantown Hospital Germantown, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $96 | $107 | $47 | 44% | — | $19 – $234 |
| 24 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $70 | $78 | $34 | 44% | — | $14 – $172 |
| 25 | Jefferson County HMA LLC Jefferson City, TN facility · fee schedule · outpatient | 1 | $127 | $127 | — | — | — | $127 – $127 |
← Payers reporting HCPCS Q4128 · Snapshot 20261111T120946Z-9134e7f7