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
4X6CM DERMAPURE ALLOGRAFT
Low
$35
Average
$353
Median
$125
High
$10.1k
Each hospital's average Humana rate, under the methodology and billing class chosen below.
419 hospitals; the 90th percentile is 6.8× 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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495 hospital rates
iThe hospitals that file a Humana 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 | $130 | $130 | — | — | — | $130 – $130 |
| 2 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 1 | $119 | $119 | — | — | — | $119 – $119 |
| 3 | Adventhealth Redmond Rome, GA fee schedule · outpatient | 1 | $360 | $360 | — | — | — | $360 – $360 |
| 4 | Amisub of South Carolina, Inc. Fort Mill, SC fee schedule · outpatient | 1 | $55 | $55 | — | — | — | $55 – $55 |
| 5 | Aspirus St. Luke’s Hospital Duluth, MN fee schedule · outpatient | 1 | $135 | $135 | — | — | — | $135 – $135 |
| 6 | BURLESON ST. JOSEPH HEALTH CENTER OF CALDWELL, TEXAS Caldwell, TX fee schedule · inpatient | 1 | $6.7k | $6.7k | — | — | — | $6.7k – $6.7k |
| 7 | BURLESON ST. JOSEPH HEALTH CENTER OF CALDWELL, TEXAS Caldwell, TX fee schedule · outpatient | 1 | $6.7k | $6.7k | — | — | — | $6.7k – $6.7k |
| 8 | Baxter County Regional Hospital, Inc. Home, AR facility · fee schedule · outpatient | 1 | $127 | $127 | — | — | — | $127 – $127 |
| 9 | Baylor Scott & White All Saints Medical Center - Fort Worth Fort Worth, TX facility · fee schedule · outpatient | 1 | $125 | $125 | — | — | — | $125 – $125 |
| 10 | Baylor Scott & White All Saints Medical Center - Fort Worth Fort Worth, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $135 | $194 | $83 | 43% | — | $135 – $311 |
| 11 | Baylor Scott & White Continuing Care Hospital Temple, TX facility · percent of total billed charges · inpatientfrom % of charges | 1 | $126 | $180 | $77 | 43% | — | $126 – $289 |
| 12 | Baylor Scott & White Continuing Care Hospital Temple, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $135 | $194 | $83 | 43% | — | $135 – $311 |
| 13 | Baylor Scott & White Heart and Vascular Hospital - Dallas Dallas, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $135 | $194 | $83 | 43% | — | $135 – $311 |
| 14 | Baylor Scott & White Heart and Vascular Hospital - Waxahachie Waxahachie, TX facility · fee schedule · outpatient | 1 | $125 | $125 | — | — | — | $125 – $125 |
| 15 | Baylor Scott & White Heart and Vascular Hospital - Waxahachie Waxahachie, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $135 | $194 | $83 | 43% | — | $135 – $311 |
| 16 | Baylor Scott & White McLane Children's Medical Center Temple, TX facility · percent of total billed charges · inpatientfrom % of charges | 1 | $126 | $180 | $77 | 43% | — | $126 – $289 |
| 17 | Baylor Scott & White McLane Children's Medical Center Temple, TX facility · percent of total billed charges · outpatientfrom % of charges | 2 | $135 | $187 | $80 | 43% | — | $126 – $311 |
| 18 | Baylor Scott & White Medical Center - Austin Austin, TX facility · fee schedule · outpatient | 1 | $125 | $125 | — | — | — | $125 – $125 |
| 19 | Baylor Scott & White Medical Center - Austin Austin, TX facility · percent of total billed charges · inpatientfrom % of charges | 1 | $126 | $180 | $77 | 43% | — | $126 – $289 |
| 20 | Baylor Scott & White Medical Center - Austin Austin, TX facility · percent of total billed charges · outpatientfrom % of charges | 2 | $135 | $187 | $80 | 43% | — | $126 – $311 |
| 21 | Baylor Scott & White Medical Center - Brenham Brenham, TX facility · percent of total billed charges · inpatientfrom % of charges | 1 | $155 | $222 | $95 | 43% | — | $155 – $356 |
| 22 | Baylor Scott & White Medical Center - Brenham Brenham, TX facility · percent of total billed charges · outpatientfrom % of charges | 2 | $155 | $208 | $90 | 43% | — | $135 – $356 |
| 23 | Baylor Scott & White Medical Center - Buda Buda, TX facility · fee schedule · outpatient | 1 | $125 | $125 | — | — | — | $125 – $125 |
| 24 | Baylor Scott & White Medical Center - Buda Buda, TX facility · percent of total billed charges · inpatientfrom % of charges | 1 | $126 | $180 | $77 | 43% | — | $126 – $289 |
| 25 | Baylor Scott & White Medical Center - Buda Buda, TX facility · percent of total billed charges · outpatientfrom % of charges | 2 | $135 | $187 | $80 | 43% | — | $126 – $311 |
← Payers reporting HCPCS Q4152 · Snapshot 20261111T120946Z-9134e7f7