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
MEMBRANE PLACENTA TISS BIODFENCE G3 4X4CM-16SQCM-Q4116-COST PER SQ CM
Low
$1
Average
$235
Median
$206
High
$857
Each hospital's average Caresource rate, under the methodology and billing class chosen below.
111 hospitals; the 90th percentile is 2.1× 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.
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122 hospital rates
iThe hospitals that file a Caresource 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 | Adena Fayette Medical Center Washington Court House, OH facility · case rate · outpatient | 1 | $254 | $254 | — | — | — | $254 – $254 |
| 2 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 2 | $179 | $179 | $58 | 32% | — | $121 – $238 |
| 3 | Beavercreek Medical Center Springfield, OH fee schedule · outpatient | 1 | $190 | $190 | — | — | — | $190 – $190 |
| 4 | Berger Hospital Circleville, OH fee schedule · outpatient | 1 | $292 | $292 | — | — | — | $292 – $292 |
| 5 | Clinton Memorial Hospital Wilmington, OH fee schedule · outpatient | 1 | $156 | $156 | — | — | — | $156 – $156 |
| 6 | Dayton Osteopathic Hospital Dayton, OH fee schedule · outpatient | 1 | $190 | $190 | — | — | — | $190 – $190 |
| 7 | Deaconess Hospital, Inc Newburgh, IN facility · case rate · outpatient | 1 | $49 | $49 | — | — | — | $49 – $49 |
| 8 | Diley Ridge Medical Center Canal Winchester, OH facility · percent of total billed charges · bothfrom % of charges | 1 | $423 | $539 | $233 | 43% | — | $329 – $864 |
| 9 | Doctors Hospital Columbus, OH fee schedule · outpatient | 1 | $292 | $292 | — | — | — | $292 – $292 |
| 10 | Dublin Methodist Hospital Dublin, OH fee schedule · outpatient | 1 | $292 | $292 | — | — | — | $292 – $292 |
| 11 | FAIRVIEW PARK HOSPITAL DUBLIN, GA fee schedule · outpatient | 1 | $198 | $198 | — | — | — | $198 – $198 |
| 12 | Fort Hamilton Hospital Hamilton, OH fee schedule · outpatient | 1 | $191 | $191 | — | — | — | $191 – $191 |
| 13 | Grady Memorial Hospital Atlanta, GA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $895 | $936 | $398 | 42% | — | $354 – $1.8k |
| 14 | Grady Memorial Hospital Atlanta, GA professional · fee schedule · outpatient | 1 | $259 | $259 | — | — | — | $259 – $259 |
| 15 | Grady Memorial Hospital Delaware, OH fee schedule · outpatient | 2 | $207 | $207 | $85 | 41% | — | $121 – $292 |
| 16 | Grant Medical Center Columbus, OH fee schedule · outpatient | 1 | $292 | $292 | — | — | — | $292 – $292 |
| 17 | Greene Memorial Hospital Inc Xenia, OH fee schedule · outpatient | 1 | $188 | $188 | — | — | — | $188 – $188 |
| 18 | Greenfield Area Medical Center Greenfield, OH facility · case rate · outpatient | 1 | $254 | $254 | — | — | — | $254 – $254 |
| 19 | Grove City Methodist Grove City, OH fee schedule · outpatient | 1 | $292 | $292 | — | — | — | $292 – $292 |
| 20 | HCA FLORIDA BAYONET POINT HOSPITAL HUDSON, FL fee schedule · outpatient | 1 | $169 | $169 | — | — | — | $169 – $169 |
| 21 | HCA FLORIDA BLAKE HOSPITAL PALMETTO, FL fee schedule · outpatient | 1 | $169 | $169 | — | — | — | $169 – $169 |
| 22 | HCA FLORIDA BRANDON HOSPITAL TEMPLE TERRACE, FL fee schedule · outpatient | 1 | $169 | $169 | — | — | — | $169 – $169 |
| 23 | HCA FLORIDA CITRUS HOSPITAL Inverness, FL fee schedule · outpatient | 1 | $169 | $169 | — | — | — | $169 – $169 |
| 24 | HCA FLORIDA ENGLEWOOD HOSPITAL VENICE, FL fee schedule · outpatient | 1 | $169 | $169 | — | — | — | $169 – $169 |
| 25 | HCA FLORIDA FAWCETT HOSPITAL CAPE CORAL, FL fee schedule · outpatient | 1 | $169 | $169 | — | — | — | $169 – $169 |
← Payers reporting HCPCS Q4140 · Snapshot 20261111T120946Z-9134e7f7