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
SPLT AGRFT T/A/L EA ADDL 100
Arlington, TX
See all hospitals reporting CPT 15101 →Price type
AMH Cath Labs LLC’s median price of $203 is 86% below the median hospital's median price ($1.4k), higher than 24% of the 1,505 hospitals reporting CPT 15101. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 5 payers, 10 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Blue Cross Blue Shield medicare advantage case rate · outpatient | $193 | $193 | — | — | — | $193 – $193 |
| 2 | Humana medicare advantage case rate · outpatient | $201 | $201 | — | — | — | $201 – $201 |
| 3 | Humana medicare advantage ppo case rate · outpatient | $201 | $201 | — | — | — | $201 – $201 |
| 4 | Molina medicare advantage case rate · outpatient | $203 | $203 | — | — | — | $203 – $203 |
| 5 | WellCare medicare advantage hmo case rate · outpatient | $203 | $203 | — | — | — | $203 – $203 |
| 6 | WellCare medicare advantage mmp case rate · outpatient | $213 | $213 | — | — | — | $213 – $213 |
| 7 | UnitedHealthcare medicare advantage ppo case rate · outpatient | $215 | $215 | — | — | — | $215 – $215 |
| 8 | UnitedHealthcare medicare advantage hmo case rate · outpatient | $219 | $219 | — | — | — | $219 – $219 |
| 9 | UnitedHealthcare all payer case rate · outpatient | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 10 | UnitedHealthcare ppo case rate · outpatient | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
Last updated: Apr 21, 2026
See Additional skin graft for larger wound area pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.