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
HC Implant Graft Purified Collagen Matrix Phmb Antimicrobial Puraply 8cm Puraplyam-Com2x4 304568
Low
$62
Average
$177
Median
$113
High
$524
Each hospital's average Ucare rate, under the methodology and billing class chosen below.
34 hospitals; the 90th percentile is 3.4× 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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53 hospital rates
iThe hospitals that file a Ucare 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 | Allina Health Systems Shakopee, MN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $86 | $101 | $61 | 61% | — | $18 – $244 |
| 2 | Allina Health Systems MN; 1175 Nininger Road. Hastings, MN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $86 | $101 | $61 | 61% | — | $18 – $244 |
| 3 | Allina Health Systems Owatonna, MN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $86 | $101 | $61 | 61% | — | $18 – $244 |
| 4 | Allina Health Systems Ulm, MN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $74 | $77 | $36 | 48% | — | $16 – $142 |
| 5 | Allina Health Systems MN 55443; 550 Osborne Road NE. Fridley, MN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $86 | $101 | $61 | 61% | — | $18 – $244 |
| 6 | Allina Health Systems Cambridge, MN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $86 | $101 | $61 | 61% | — | $18 – $244 |
| 7 | Allina Health Systems Faribualt, MN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $86 | $101 | $61 | 61% | — | $18 – $244 |
| 8 | Allina Health Systems River Falls, WI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $86 | $101 | $61 | 61% | — | $18 – $244 |
| 9 | Allina Health Systems Minneapolis, MN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $86 | $101 | $61 | 61% | — | $18 – $244 |
| 10 | Allina Health Systems Buffalo, MN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $86 | $101 | $61 | 61% | — | $18 – $244 |
| 11 | Alomere Health Alexandria, MN facility · fee schedule · outpatient | 1 | $148 | $148 | — | — | — | $148 – $148 |
| 12 | GILLETTE CHILDREN'S SPECIALTY HEALTHCARE PAUL, MN professional · fee schedule · outpatient | 1 | $106 | $106 | — | — | — | $106 – $106 |
| 13 | Mayo Clinic Health System Osseo, WI facility · percent of total billed charges · bothfrom % of charges | 1 | $62 | $62 | — | — | — | $62 – $62 |
| 14 | Mayo Clinic Health System Menomonie, WI facility · percent of total billed charges · bothfrom % of charges | 1 | $60 | $60 | — | — | — | $60 – $60 |
| 15 | Mayo Clinic Health System Menomonie, WI professional · fee schedule · outpatient | 2 | $103 | $103 | $4 | 4% | — | $99 – $107 |
| 16 | Mayo Clinic Health System Bloomer, WI facility · percent of total billed charges · bothfrom % of charges | 1 | $69 | $69 | — | — | — | $69 – $69 |
| 17 | Mayo Clinic Health System Bloomer, WI professional · fee schedule · outpatient | 2 | $103 | $103 | $4 | 4% | — | $99 – $107 |
| 18 | Mayo Clinic Health System Eau Claire 54703-5270 facility · other · both | 1 | $132 | $132 | — | — | — | $132 – $132 |
| 19 | Mayo Clinic Health System Eau Claire 54703-5270 professional · fee schedule · outpatient | 2 | $103 | $103 | $4 | 4% | — | $99 – $107 |
| 20 | Mayo Clinic Health System Sparta, WI facility · percent of total billed charges · bothfrom % of charges | 3 | $45 | $83 | $58 | 70% | — | $39 – $165 |
| 21 | Mayo Clinic Health System Sparta, WI professional · fee schedule · outpatient | 2 | $120 | $120 | $20 | 17% | — | $99 – $140 |
| 22 | Mayo Clinic Health System Sparta, WI professional · percent of total billed charges · outpatientfrom % of charges | 1 | $165 | $165 | — | — | — | $165 – $165 |
| 23 | Mayo Clinic Health System Barron, WI facility · percent of total billed charges · bothfrom % of charges | 1 | $61 | $61 | — | — | — | $61 – $61 |
| 24 | Mayo Clinic Health System Barron, WI professional · fee schedule · outpatient | 2 | $103 | $103 | $4 | 4% | — | $99 – $107 |
| 25 | Memorial Hospital of Boscobel Boscobel, WI facility · percent of total billed charges · bothfrom % of charges | 1 | $175 | $175 | — | — | — | $175 – $175 |
← Payers reporting HCPCS Q4196 · Snapshot 20261111T120946Z-9134e7f7