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
ALLOGRAFT PLACENTAL FENESTR SHEET 2X3CM (6 SQ CM)
Low
$134
Average
$178
Median
$163
High
$270
Each hospital's average Oscar rate, under the methodology and billing class chosen below.
39 hospitals; the 90th percentile is 1.7× 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.
Filter by billing methodology
Filter by billing class
39 hospital rates
iThe hospitals that file a Oscar 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 | Adventhealth Port Charlotte Port Charlotte, FL fee schedule · outpatient | 1 | $237 | $237 | — | — | — | $237 – $237 |
| 2 | Bethesda Hospital Inc. Lebanon, OH facility · fee schedule · outpatient | 1 | $182 | $182 | — | — | — | $182 – $182 |
| 3 | Grady Memorial Hospital Atlanta, GA professional · fee schedule · outpatient | 1 | $134 | $134 | — | — | — | $134 – $134 |
| 4 | HonorHealth Florence Medical Center Florence, AZ facility · fee schedule · outpatient | 1 | $137 | $137 | $39 | 28% | — | $98 – $175 |
| 5 | Honorhealth Deer Valley Medical Center Phoenix, AZ facility · fee schedule · outpatient | 1 | $137 | $137 | $39 | 28% | — | $98 – $175 |
| 6 | Honorhealth Four Peaks Medical Center Mesa, AZ facility · fee schedule · outpatient | 1 | $137 | $137 | $39 | 28% | — | $98 – $175 |
| 7 | Honorhealth John C. Lincoln Medical Center Phoenix, AZ facility · fee schedule · outpatient | 1 | $137 | $137 | $39 | 28% | — | $98 – $175 |
| 8 | Honorhealth Scottsdale Osborn Medical Center Scottsdale, AZ facility · fee schedule · outpatient | 1 | $137 | $137 | $39 | 28% | — | $98 – $175 |
| 9 | Honorhealth Scottsdale Shea Medical Center Scottsdale, AZ facility · fee schedule · outpatient | 1 | $137 | $137 | $39 | 28% | — | $98 – $175 |
| 10 | Honorhealth Scottsdale Thompson Peak Med Center Scottsdale, AZ facility · fee schedule · outpatient | 1 | $137 | $137 | $39 | 28% | — | $98 – $175 |
| 11 | Honorhealth Sonoran Crossing Medical Center Phoenix, AZ facility · fee schedule · outpatient | 1 | $137 | $137 | $39 | 28% | — | $98 – $175 |
| 12 | Ingalls Memorial Hospital Harvey, IL fee schedule · outpatient | 1 | $147 | $147 | — | — | — | $147 – $147 |
| 13 | McCullough-Hyde Memorial Hospital, Inc. Oxford, OH facility · fee schedule · outpatient | 1 | $182 | $182 | — | — | — | $182 – $182 |
| 14 | Methodist Hospitals of Dallas Coppell, TX other · both | 1 | $163 | $163 | — | — | — | $163 – $163 |
| 15 | Methodist Hospitals of Dallas Mansfield, TX other · both | 1 | $163 | $163 | — | — | — | $163 – $163 |
| 16 | Methodist Hospitals of Dallas Celina, TX other · both | 1 | $163 | $163 | — | — | — | $163 – $163 |
| 17 | Methodist Hospitals of Dallas Midlothian, TX other · both | 1 | $163 | $163 | — | — | — | $163 – $163 |
| 18 | Methodist Hospitals of Dallas Dallas, TX other · both | 1 | $163 | $163 | — | — | — | $163 – $163 |
| 19 | Methodist Hospitals of Dallas Souhtlake, TX other · both | 1 | $163 | $163 | — | — | — | $163 – $163 |
| 20 | Methodist Hospitals of Dallas Richardson, TX other · both | 1 | $163 | $163 | — | — | — | $163 – $163 |
| 21 | Methodist Hospitals of Dallas Richardson, TX other · both | 1 | $163 | $163 | — | — | — | $163 – $163 |
| 22 | OHI West, Inc. Pinellas Park, FL fee schedule · outpatient | 1 | $270 | $270 | — | — | — | $270 – $270 |
| 23 | SSM Health Care of Oklahoma, Inc Midwest City, OK fee schedule · outpatient | 1 | $157 | $157 | — | — | — | $157 – $157 |
| 24 | SSM Health Care of Oklahoma, Inc Oklahoma City, OK fee schedule · outpatient | 1 | $157 | $157 | — | — | — | $157 – $157 |
| 25 | SSM-SLUH, Inc. Saint Louis, MO fee schedule · outpatient | 1 | $150 | $150 | — | — | — | $150 – $150 |
← Payers reporting HCPCS Q4201 · Snapshot 20261111T120946Z-9134e7f7