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
ALLOGRAFT PRTCLT TISS NEOX FLO 100MG
Low
$120
Average
$804
Median
$132
High
$2.7k
Each hospital's average Cigna Healthspring rate, under the methodology and billing class chosen below.
17 hospitals; the 90th percentile is 19.4× 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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17 hospital rates
iThe hospitals that file a Cigna Healthspring 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 | Carolinas Medical Center Davidson, NC percent of total billed charges · outpatientfrom % of charges | 1 | $363 | $316 | $140 | 44% | — | $96 – $513 |
| 2 | Conway Regional Medical Center Conway, AR facility · fee schedule · outpatient | 1 | $120 | $120 | — | — | — | $120 – $120 |
| 3 | Holy Redeemer Health System Meadowbrook, PA facility · case rate · outpatient | 1 | $132 | $132 | — | — | — | $132 – $132 |
| 4 | Kemper CAH, Inc. DeKalb, MS other · outpatient | 1 | $2.2k | $2.5k | $1.3k | 53% | — | $758 – $5.0k |
| 5 | Laird Hospital, Inc. Union, MS other · outpatient | 1 | $2.4k | $2.7k | $1.3k | 49% | — | $796 – $5.2k |
| 6 | Northwest Hospital LLC Tucson, AZ facility · fee schedule · outpatient | 1 | $131 | $131 | — | — | — | $131 – $131 |
| 7 | Northwest Sahurita Hospital LLC Tucson, AZ facility · fee schedule · outpatient | 1 | $131 | $131 | — | — | — | $131 – $131 |
| 8 | Northwest Sahurita Hospital LLC Sahuarita, AZ facility · fee schedule · outpatient | 1 | $131 | $131 | — | — | — | $131 – $131 |
| 9 | Northwestern Medicine Valley West Hospital Sandwich, IL percent of total billed charges · outpatientfrom % of charges | 1 | $69 | $180 | $169 | 94% | — | $38 – $468 |
| 10 | Oro Valley Hospital LLC Tucson, AZ facility · fee schedule · outpatient | 1 | $131 | $131 | — | — | — | $131 – $131 |
| 11 | Rush Hospital/Butler, Inc. Butler, AL other · outpatient | 1 | $1.7k | $2.0k | $960 | 49% | — | $569 – $3.7k |
| 12 | Rush Medical Foundation Quitman, MS other · outpatient | 1 | $2.2k | $2.5k | $1.2k | 49% | — | $733 – $4.8k |
| 13 | Scott Regional Medical Center, Inc. Morton, MS other · outpatient | 1 | $1.9k | $2.2k | $1.1k | 49% | — | $632 – $4.1k |
| 14 | USA Health University Hospital Mobile, AL facility · case rate · outpatient | 1 | $127 | $127 | — | — | — | $127 – $127 |
| 15 | University of Arkansas for Medical Sciences Little Rock, AR facility · other · outpatient | 1 | $132 | $132 | — | — | — | $132 – $132 |
| 16 | University of Virginia Culpeper Medical Center Culpeper, VA other · both | 1 | $129 | $129 | — | — | — | $129 – $129 |
| 17 | University of Virginia Prince William Medical Center Manassas, VA other · both | 1 | $129 | $129 | — | — | — | $129 – $129 |
← Payers reporting HCPCS Q4148 · Snapshot 20261111T120946Z-9134e7f7