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
$0
Average
$455
Median
$223
High
$5.4k
Each hospital's average Molina rate, under the methodology and billing class chosen below.
333 hospitals; the 90th percentile is 8.6× 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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463 hospital rates
iThe hospitals that file a Molina 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 | 1 | $131 | $131 | — | — | — | $131 – $131 |
| 2 | AMH Cath Labs LLC Arlington, TX percent of total billed charges · outpatientfrom % of charges | 1 | $85 | $106 | $38 | 36% | — | $82 – $171 |
| 3 | ARH Mary Breckinridge Health Services, Inc Barbourville, KY percent of total billed charges · outpatientfrom % of charges | 1 | $110 | $110 | $0 | 0% | — | $109 – $110 |
| 4 | ARH Mary Breckinridge Health Services, Inc Hayden, KY percent of total billed charges · outpatientfrom % of charges | 1 | $97 | $97 | $0 | 0% | — | $96 – $97 |
| 5 | ARH Mary Breckinridge Health Services, Inc Martin, KY percent of total billed charges · outpatientfrom % of charges | 1 | $129 | $129 | $1 | 0% | — | $128 – $129 |
| 6 | ARH Tug Valley Health Services, Inc. Paintsville, KY percent of total billed charges · outpatientfrom % of charges | 1 | $90 | $90 | $0 | 0% | — | $90 – $91 |
| 7 | ARH Tug Valley Health Services, Inc. Prestonsburg, KY percent of total billed charges · outpatientfrom % of charges | 1 | $187 | $187 | $1 | 0% | — | $186 – $188 |
| 8 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH per diem · inpatient | 2 | $5.4k | $5.4k | — | — | — | $5.4k – $5.4k |
| 9 | Adena Fayette Medical Center Washington Court House, OH facility · case rate · outpatient | 1 | $261 | $261 | — | — | — | $261 – $261 |
| 10 | Adena Fayette Medical Center Washington Court House, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $300 | $1.9k | $2.3k | 122% | — | $119 – $6.8k |
| 11 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 2 | $181 | $181 | $62 | 34% | — | $119 – $244 |
| 12 | Agnesian Healthcare Inc. Fond Du Lac, WI fee schedule · outpatient | 1 | $92 | $92 | — | — | — | $92 – $92 |
| 13 | Amisub of South Carolina, Inc. Fort Mill, SC fee schedule · outpatient | 1 | $247 | $247 | — | — | — | $247 – $247 |
| 14 | Appalachian Regional Healthcare, Inc. Liberty, KY percent of total billed charges · outpatientfrom % of charges | 1 | $135 | $135 | $1 | 0% | — | $135 – $136 |
| 15 | Appalachian Regional Healthcare, Inc. McDowell, KY percent of total billed charges · outpatientfrom % of charges | 1 | $110 | $110 | $0 | 0% | — | $109 – $110 |
| 16 | Appalachian Regional Healthcare, Inc. Middlesboro, KY percent of total billed charges · outpatientfrom % of charges | 1 | $116 | $116 | $1 | 0% | — | $116 – $117 |
| 17 | Appalachian Regional Healthcare, Inc. Williamson, KY percent of total billed charges · outpatientfrom % of charges | 1 | $97 | $97 | $0 | 0% | — | $96 – $97 |
| 18 | Appalachian Regional Healthcare, Inc. Hazard, KY percent of total billed charges · outpatientfrom % of charges | 1 | $142 | $142 | $1 | 0% | — | $141 – $142 |
| 19 | Appalachian Regional Healthcare, Inc. Harlan, KY percent of total billed charges · outpatientfrom % of charges | 1 | $103 | $103 | $0 | 0% | — | $103 – $104 |
| 20 | Aurora BayCare Medical Center Green Bay, WI fee schedule · outpatient | 1 | $592 | $592 | — | — | — | $592 – $592 |
| 21 | Aurora Lakeland Medical Center Elkhorn, WI fee schedule · outpatient | 1 | $592 | $592 | — | — | — | $592 – $592 |
| 22 | Aurora Medical Center Bay Area Marinette, WI fee schedule · outpatient | 1 | $592 | $592 | — | — | — | $592 – $592 |
| 23 | Aurora Medical Center Burlington Burlington, WI fee schedule · outpatient | 1 | $592 | $592 | — | — | — | $592 – $592 |
| 24 | Aurora Medical Center Fond du Lac Fond Du Lac, WI fee schedule · outpatient | 1 | $592 | $592 | — | — | — | $592 – $592 |
| 25 | Aurora Medical Center Grafton Grafton, WI fee schedule · outpatient | 1 | $592 | $592 | — | — | — | $592 – $592 |
← Payers reporting HCPCS Q4187 · Snapshot 20261111T120946Z-9134e7f7