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
$4
Average
$118
Median
$125
High
$171
Each hospital's average WellCare rate, under the methodology and billing class chosen below.
146 hospitals; the 90th percentile is 1.9× 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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162 hospital rates
iThe hospitals that file a WellCare 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 | 2 | $135 | $135 | $3 | 2% | — | $131 – $138 |
| 2 | Acadia Hospital Bangor, ME professional · fee schedule · outpatient | 1 | $78 | $78 | — | — | — | $78 – $78 |
| 3 | Adventhealth Port Charlotte Port Charlotte, FL fee schedule · outpatient | 1 | $146 | $146 | — | — | — | $146 – $146 |
| 4 | Agnesian Healthcare Inc. Fond Du Lac, WI fee schedule · outpatient | 1 | $126 | $126 | — | — | — | $126 – $126 |
| 5 | Baptist Health Medical Center - North Little Rock Rock, AR fee schedule · outpatient | 1 | $125 | $125 | — | — | — | $125 – $125 |
| 6 | Blue Hill Memorial Hospital Hill, ME facility · percent of total billed charges · outpatientfrom % of charges | 1 | $44 | $44 | — | — | — | $44 – $44 |
| 7 | Blue Hill Memorial Hospital Hill, ME professional · fee schedule · outpatient | 1 | $78 | $78 | — | — | — | $78 – $78 |
| 8 | CLAIBORNE MEDICAL CENTER Tazewell, TN fee schedule · outpatient | 1 | $127 | $127 | — | — | — | $127 – $127 |
| 9 | CLOVIS COMMUNITY MEDICAL CENTER Clovis, CA facility · case rate · outpatient | 1 | $160 | $160 | — | — | — | $160 – $160 |
| 10 | CUMBERLAND MEDICAL CENTER, INC. Crossville, TN fee schedule · outpatient | 1 | $127 | $127 | — | — | — | $127 – $127 |
| 11 | Canton-Potsdam Hospital Potsdam, NY facility · fee schedule · outpatient | 2 | $123 | $123 | — | — | — | $123 – $123 |
| 12 | Carle BroMenn Medical Center Normal, IL case rate · outpatient | 1 | $133 | $133 | — | — | — | $133 – $133 |
| 13 | Carle Eureka Hospital Eureka, IL case rate · outpatient | 1 | $133 | $133 | — | — | — | $133 – $133 |
| 14 | Central Maine Medical Center Lewiston, ME fee schedule · outpatient | 1 | $127 | $127 | — | — | — | $127 – $127 |
| 15 | Charles A. Dean Memorial Hospital Greenville, ME professional · fee schedule · outpatient | 1 | $81 | $81 | — | — | — | $81 – $81 |
| 16 | Clallam County Public Hospital District 2 DBA Olympic Medical Center Port Angeles, WA fee schedule · outpatient | 1 | $171 | $171 | — | — | — | $171 – $171 |
| 17 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · fee schedule · outpatient | 1 | $130 | $130 | — | — | — | $130 – $130 |
| 18 | Conway Hospital, Inc. Conway, SC professional · fee schedule · outpatient | 1 | $76 | $76 | — | — | — | $76 – $76 |
| 19 | Danbury Hospital New Milford, CT fee schedule · outpatient | 1 | $152 | $152 | — | — | — | $152 – $152 |
| 20 | ERIE COUNTY MEDICAL CENTER CORPORATION Buffalo, NY fee schedule · outpatient | 1 | $155 | $155 | — | — | — | $155 – $155 |
| 21 | Eastern Maine Medical Center Bangor, ME professional · fee schedule · outpatient | 1 | $78 | $78 | — | — | — | $78 – $78 |
| 22 | F.F. Thompson Hospital Canandaigua, NY fee schedule · outpatient | 1 | $127 | $127 | — | — | — | $127 – $127 |
| 23 | FORT LOUDOUN MEDICAL CENTER Lenoir City, TN fee schedule · outpatient | 1 | $119 | $119 | — | — | — | $119 – $119 |
| 24 | FORT SANDERS REGIONAL MEDICAL CENTER Knoxville, TN fee schedule · outpatient | 1 | $119 | $119 | — | — | — | $119 – $119 |
| 25 | FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER Fresno, CA facility · fee schedule · outpatient | 1 | $127 | $127 | — | — | — | $127 – $127 |
← Payers reporting HCPCS Q4201 · Snapshot 20261111T120946Z-9134e7f7