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 MIRODERM FEN 2CMX3CM
Low
$98
Average
$482
Median
$162
High
$5.0k
Each hospital's average First Health rate, under the methodology and billing class chosen below.
23 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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24 hospital rates
iThe hospitals that file a First Health 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 · fee schedule · outpatient | 1 | $162 | $162 | — | — | — | $162 – $162 |
| 2 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 1 | $162 | $162 | — | — | — | $162 – $162 |
| 3 | Barnes Jewish Hospital St. Louis, MO percent of total billed charges · bothfrom % of charges | 1 | $169 | $169 | — | — | — | $169 – $169 |
| 4 | Broaddus Hospital Association Inc Philippi, WV professional · fee schedule · both | 1 | $102 | $102 | — | — | — | $102 – $102 |
| 5 | CentraState Medical Center Freehold Township, NJ percent of total billed charges · bothfrom % of charges | 1 | $4.8k | $5.0k | $1.4k | 28% | — | $3.5k – $8.1k |
| 6 | Christian Hospital St. Louis, MO percent of total billed charges · bothfrom % of charges | 1 | $169 | $176 | $29 | 17% | — | $145 – $231 |
| 7 | DIGNITY HEALTH Phoenix, AZ fee schedule · inpatient | 1 | $376 | $362 | $110 | 30% | — | $221 – $489 |
| 8 | DIGNITY HEALTH Phoenix, AZ fee schedule · outpatient | 1 | $376 | $362 | $110 | 30% | — | $221 – $489 |
| 9 | Davis Medical Center Elkins, WV professional · fee schedule · both | 1 | $102 | $102 | — | — | — | $102 – $102 |
| 10 | Greenfield Area Medical Center Greenfield, OH facility · fee schedule · outpatient | 1 | $162 | $162 | — | — | — | $162 – $162 |
| 11 | Hackensack Meridian Mountainside Medical Center Montclair, NJ facility · percent of total billed charges · bothfrom % of charges | 2 | $2.1k | $2.1k | $372 | 18% | — | $1.6k – $2.6k |
| 12 | Holy Name Teaneck, NJ facility · percent of total billed charges · outpatientfrom % of charges | 1 | $700 | $768 | $146 | 19% | — | $613 – $970 |
| 13 | Mercy Hospital South Louis, MO facility · percent of total billed charges · outpatientfrom % of charges | 3 | $94 | $98 | $17 | 17% | — | $79 – $130 |
| 14 | Mercy Hospitals East Communities dba Mercy Hospital Washington Washington, MO facility · percent of total billed charges · outpatientfrom % of charges | 2 | $129 | $129 | $14 | 11% | — | $113 – $144 |
| 15 | Orlando Health Melbourne Hospital Melbourne, FL fee schedule · outpatient | 1 | $253 | $253 | — | — | — | $253 – $253 |
| 16 | Orlando Health Sebastian River Hospital Sebastian, FL fee schedule · outpatient | 1 | $253 | $253 | — | — | — | $253 – $253 |
| 17 | Pike Health Services Inc Waverly, OH facility · fee schedule · outpatient | 1 | $162 | $162 | — | — | — | $162 – $162 |
| 18 | Reid Health Richmond, IN other · both | 1 | $127 | $127 | — | — | — | $127 – $127 |
| 19 | St Luke's Magic Valley Regional Medical Center, LTD Jerome, ID percent of total billed charges · bothfrom % of charges | 2 | $135 | $137 | $26 | 19% | — | $106 – $170 |
| 20 | St Luke's McCall, LTD McCall, ID percent of total billed charges · outpatientfrom % of charges | 1 | $144 | $144 | $26 | 18% | — | $119 – $170 |
| 21 | St Luke's Nampa Medical Center, LTD Nampa, ID percent of total billed charges · bothfrom % of charges | 2 | $127 | $127 | $23 | 18% | — | $103 – $152 |
| 22 | St Luke's Regional Medical Center, LTD Mountain Home, ID percent of total billed charges · bothfrom % of charges | 2 | $127 | $127 | $23 | 18% | — | $103 – $152 |
| 23 | St Luke's Wood River Medical Center, LTD Ketchum, ID percent of total billed charges · bothfrom % of charges | 2 | $146 | $146 | $26 | 18% | — | $119 – $174 |
| 24 | Webster Memorial Hospital Inc Cowen, WV professional · fee schedule · both | 1 | $102 | $102 | — | — | — | $102 – $102 |
← Payers reporting HCPCS Q4175 · Snapshot 20261111T120946Z-9134e7f7