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
Grft Sft Tiss Epicord 1x2cm (per Sq Cm)
Low
$130
Average
$838
Median
$484
High
$5.4k
Each hospital's average Medica rate, under the methodology and billing class chosen below.
82 hospitals; the 90th percentile is 14.7× 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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109 hospital rates
iThe hospitals that file a Medica 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 | Allen Memorial Hospital Corporation Waterloo, IA percent of total billed charges · outpatientfrom % of charges | 1 | $440 | $440 | $25 | 6% | — | $415 – $465 |
| 2 | Altru Hospital Grand Forks, ND facility · fee schedule · outpatient | 4 | $116 | $139 | $66 | 47% | — | $83 – $243 |
| 3 | Altru Hospital Devils Lake Devils Lake, ND facility · fee schedule · outpatient | 4 | $116 | $139 | $66 | 47% | — | $83 – $243 |
| 4 | Avera Behavioral Health Hospital Sioux Falls, SD percent of total billed charges · outpatientfrom % of charges | 2 | $2.7k | $2.7k | $227 | 8% | — | $2.5k – $3.0k |
| 5 | Avera Gregory Hospital Gregory, SD percent of total billed charges · inpatientfrom % of charges | 2 | $1.9k | $1.9k | $163 | 9% | — | $1.7k – $2.1k |
| 6 | Avera Gregory Hospital Gregory, SD percent of total billed charges · outpatientfrom % of charges | 2 | $1.9k | $1.9k | $167 | 9% | — | $1.8k – $2.1k |
| 7 | Avera McKennan Hospital Sioux Falls, SD percent of total billed charges · outpatientfrom % of charges | 2 | $2.7k | $2.7k | $227 | 8% | — | $2.5k – $3.0k |
| 8 | Avera Queen of Peace Mitchell, SD percent of total billed charges · inpatientfrom % of charges | 2 | $2.6k | $2.6k | $212 | 8% | — | $2.4k – $2.8k |
| 9 | Avera Queen of Peace Mitchell, SD percent of total billed charges · outpatientfrom % of charges | 2 | $2.7k | $2.7k | $222 | 8% | — | $2.4k – $2.9k |
| 10 | Avera Sacred Heart Hospital Yankton, SD percent of total billed charges · inpatientfrom % of charges | 2 | $1.9k | $1.9k | $163 | 9% | — | $1.7k – $2.1k |
| 11 | Avera Sacred Heart Hospital Yankton, SD percent of total billed charges · outpatientfrom % of charges | 2 | $1.9k | $1.9k | $167 | 9% | — | $1.8k – $2.1k |
| 12 | Avera Specialty Hospital Sioux Falls, SD percent of total billed charges · outpatientfrom % of charges | 2 | $2.7k | $2.7k | $227 | 8% | — | $2.5k – $3.0k |
| 13 | BAPTIST HOSPITAL OF MIAMI PLANTATION, FL fee schedule · both | 1 | $139 | $139 | — | — | — | $139 – $139 |
| 14 | BETHESDA HOSPITAL BOYNTON BEACH, FL fee schedule · both | 1 | $130 | $130 | — | — | — | $130 – $130 |
| 15 | BSA Hospital Amarillo, TX facility · percent of total billed charges · bothfrom % of charges | 1 | $2.6k | $2.4k | $1.1k | 49% | — | $644 – $4.2k |
| 16 | Brookings Health System Brookings, SD fee schedule · outpatient | 1 | $1.7k | $1.7k | $300 | 18% | — | $1.4k – $2.0k |
| 17 | Brookings Health System Brookings, SD percent of total billed charges · outpatientfrom % of charges | 1 | $995 | $992 | $329 | 33% | — | $534 – $1.4k |
| 18 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $391 | $533 | $200 | 38% | — | $391 – $816 |
| 19 | Catholic Health Initiatives-Iowa Corp West Des Moines, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $391 | $533 | $200 | 38% | — | $391 – $816 |
| 20 | Central Community Hospital Elkader, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $590 | $803 | $301 | 38% | — | $590 – $1.2k |
| 21 | Covenant Medical Center Inc Waterloo, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $428 | $582 | $218 | 38% | — | $427 – $891 |
| 22 | Curators of the University of Missouri Jefferson City, MO facility · fee schedule · outpatient | 1 | $428 | $428 | — | — | — | $428 – $428 |
| 23 | DOCTORS HOSPITAL CORAL GABLES, FL fee schedule · both | 1 | $139 | $139 | — | — | — | $139 – $139 |
| 24 | FISHERMENS HEALTH, INC MARATHON, FL percent of total billed charges · bothfrom % of charges | 1 | $2.7k | $2.8k | $953 | 34% | — | $1.6k – $4.3k |
| 25 | Fairview Bethesda Hospital St. Paul, MN fee schedule · both | 8 | $483 | $412 | $123 | 30% | — | $245 – $533 |
← Payers reporting HCPCS Q4187 · Snapshot 20261111T120946Z-9134e7f7