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
Axolotl graf dualgraf sq cm
Low
$848
Average
$1.2k
Median
$1.1k
High
$2.7k
Each hospital's average Cigna rate, under the methodology and billing class chosen below.
72 hospitals; the 90th percentile is 1.8× 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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73 hospital rates
iThe hospitals that file a Cigna 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 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 1 | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
| 2 | Allen Memorial Hospital Corporation Waterloo, IA fee schedule · both | 1 | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 3 | Alomere Health Alexandria, MN facility · fee schedule · outpatient | 1 | $2.7k | $2.7k | — | — | — | $2.7k – $2.7k |
| 4 | Boulder Community Health Lafayette, CO facility · fee schedule · outpatient | 1 | $1.2k | $1.2k | $43 | 4% | — | $1.2k – $1.2k |
| 5 | CATHOLIC HEALTH INIATIVES COLORADO Westminster, CO fee schedule · outpatient | 2 | $926 | $926 | $34 | 4% | — | $893 – $960 |
| 6 | CATHOLIC HEALTH INITIATIVES COLORADO Colorado Springs, CO fee schedule · outpatient | 1 | $960 | $960 | — | — | — | $960 – $960 |
| 7 | CATHOLIC HEALTH INITIATIVES COLORADO Lakewood, CO fee schedule · outpatient | 2 | $926 | $926 | $34 | 4% | — | $893 – $960 |
| 8 | CATHOLIC HEALTH INITIATIVES COLORADO Colorado Springs, CO fee schedule · outpatient | 1 | $960 | $960 | — | — | — | $960 – $960 |
| 9 | CENTENNIAL HOSPITAL A CAMPUS OF TMCA ENGLEWOOD, CO fee schedule · outpatient | 1 | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 10 | Central Iowa Hospital Corporation Des Moines, IA fee schedule · both | 1 | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 11 | Central Iowa Hospital Corporation West Des Moines, IA fee schedule · both | 1 | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 12 | Cheshire Medical Center Keene, NH professional · fee schedule · outpatient | 2 | $848 | $848 | — | — | — | $848 – $848 |
| 13 | Danbury Hospital New Milford, CT fee schedule · outpatient | 1 | $958 | $958 | — | — | — | $958 – $958 |
| 14 | Doctors’ Hospital of Williamsburg Williamsburg, VA fee schedule · outpatient | 1 | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 15 | Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · both | 1 | $1.0k | $1.0k | $88 | 9% | — | $924 – $1.1k |
| 16 | GOOD SAMARITAN MEDICAL CENTER, LLC DBA LAFAYETTE, CO facility · fee schedule · outpatient | 11 | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 17 | Grinnell Regional Medical Center Grinnell, IA fee schedule · both | 1 | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 18 | HCA HEALTHONE AURORA Aurora, CO fee schedule · outpatient | 1 | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 19 | HCA HEALTHONE BELMAR ER LAKEWOOD, CO fee schedule · outpatient | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 20 | HCA HEALTHONE CENTRAL PARK ER DENVER, CO fee schedule · outpatient | 1 | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 21 | HCA HEALTHONE MOUNTAIN RIDGE Thornton, CO fee schedule · outpatient | 1 | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 22 | HCA HEALTHONE NORTHEAST ER THORNTON, CO fee schedule · outpatient | 1 | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 23 | HCA HEALTHONE PRESBYTERIAN ST LUKES Denver, CO fee schedule · outpatient | 1 | $2.2k | $2.2k | — | — | — | $2.2k – $2.2k |
| 24 | HCA HEALTHONE ROSE Denver, CO fee schedule · outpatient | 1 | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 25 | HCA HEALTHONE SKY RIDGE Lone Tree, CO fee schedule · outpatient | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
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