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
SKIN GRAFT 4X2CM ALLOGRFT WET ALLOWRAP AMNION #3102-2004
Low
$78
Average
$639
Median
$143
High
$9.3k
Each hospital's average WellCare rate, under the methodology and billing class chosen below.
190 hospitals; the 90th percentile is 23.3× 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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195 hospital rates
iThe hospitals that file a WellCare 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 | AMH Cath Labs LLC Arlington, TX case rate · outpatient | 2 | $135 | $135 | $3 | 2% | — | $131 – $138 |
| 2 | ARH Mary Breckinridge Health Services, Inc Barbourville, KY percent of total billed charges · outpatientfrom % of charges | 2 | $182 | $182 | — | — | — | $182 – $182 |
| 3 | ARH Mary Breckinridge Health Services, Inc Hayden, KY percent of total billed charges · outpatientfrom % of charges | 2 | $160 | $160 | — | — | — | $160 – $160 |
| 4 | ARH Mary Breckinridge Health Services, Inc Martin, KY percent of total billed charges · outpatientfrom % of charges | 2 | $213 | $213 | $1 | 0% | — | $212 – $214 |
| 5 | Acadia Hospital Bangor, ME professional · fee schedule · outpatient | 1 | $80 | $80 | — | — | — | $80 – $80 |
| 6 | Agnesian Healthcare Inc. Fond Du Lac, WI fee schedule · outpatient | 1 | $126 | $126 | — | — | — | $126 – $126 |
| 7 | Alleghany County Memorial Hospital, Inc Sparta, NC facility · percent of total billed charges · outpatientfrom % of charges | 1 | $727 | $727 | — | — | — | $727 – $727 |
| 8 | Appalachian Regional Healthcare, Inc. Liberty, KY percent of total billed charges · inpatientfrom % of charges | 1 | $224 | $224 | — | — | — | $224 – $224 |
| 9 | Appalachian Regional Healthcare, Inc. Liberty, KY percent of total billed charges · outpatientfrom % of charges | 1 | $224 | $224 | — | — | — | $224 – $224 |
| 10 | Appalachian Regional Healthcare, Inc. McDowell, KY percent of total billed charges · outpatientfrom % of charges | 2 | $181 | $181 | $1 | 0% | — | $180 – $182 |
| 11 | Appalachian Regional Healthcare, Inc. Hinton, WV percent of total billed charges · outpatientfrom % of charges | 1 | $214 | $214 | — | — | — | $214 – $214 |
| 12 | Appalachian Regional Healthcare, Inc. Middlesboro, KY percent of total billed charges · outpatientfrom % of charges | 1 | $265 | $265 | — | — | — | $265 – $265 |
| 13 | Appalachian Regional Healthcare, Inc. Williamson, KY percent of total billed charges · outpatientfrom % of charges | 1 | $243 | $243 | — | — | — | $243 – $243 |
| 14 | Appalachian Regional Healthcare, Inc. Hazard, KY percent of total billed charges · outpatientfrom % of charges | 1 | $254 | $254 | — | — | — | $254 – $254 |
| 15 | Appalachian Regional Healthcare, Inc. Harlan, KY percent of total billed charges · outpatientfrom % of charges | 1 | $275 | $275 | — | — | — | $275 – $275 |
| 16 | Atrium Health Hospitals Inc Kings Mountain, NC percent of total billed charges · outpatientfrom % of charges | 1 | $244 | $244 | — | — | — | $244 – $244 |
| 17 | Atrium Health Hospitals Inc Lincolnton, NC percent of total billed charges · outpatientfrom % of charges | 1 | $195 | $195 | — | — | — | $195 – $195 |
| 18 | Atrium Health Hospitals Inc Wadesboro, NC percent of total billed charges · outpatientfrom % of charges | 1 | $259 | $259 | — | — | — | $259 – $259 |
| 19 | Baptist Health Medical Center - Conway Conway, AR fee schedule · outpatient | 1 | $125 | $125 | — | — | — | $125 – $125 |
| 20 | Baptist Health Medical Center - Magnolia Magnolia, AR fee schedule · outpatient | 1 | $125 | $125 | — | — | — | $125 – $125 |
| 21 | Baxter County Regional Hospital, Inc. Home, AR facility · fee schedule · outpatient | 1 | $124 | $124 | — | — | — | $124 – $124 |
| 22 | Blue Hill Memorial Hospital Hill, ME professional · fee schedule · outpatient | 1 | $80 | $80 | — | — | — | $80 – $80 |
| 23 | CLAIBORNE MEDICAL CENTER Tazewell, TN fee schedule · outpatient | 1 | $127 | $127 | — | — | — | $127 – $127 |
| 24 | CLOVIS COMMUNITY MEDICAL CENTER Clovis, CA facility · case rate · outpatient | 1 | $160 | $160 | — | — | — | $160 – $160 |
| 25 | CUMBERLAND MEDICAL CENTER, INC. Crossville, TN fee schedule · outpatient | 1 | $127 | $127 | — | — | — | $127 – $127 |
← Payers reporting HCPCS Q4150 · Snapshot 20261111T120946Z-9134e7f7