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
GRAFT SKIN L5 CM X W5 CM ALLOGRAFT HYDRATE ALLOPATCH HD THK.8-1.7 MM THICK ACELLULAR DERMIS
Macon, GA
See all hospitals reporting HCPCS Q4128 →Price type
Central Georgia Rehabilitation LLC’s median price of $1.1k is 724% above the median hospital's median price ($133), higher than 77% of the 1,543 hospitals reporting HCPCS Q4128. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 9 payers, 25 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 | Anthem hmo/ppo fee schedule · both | $31 | $31 | — | — | — | $31 – $31 |
| 2 | Humana hmo/pos fee schedule · both | $45 | $45 | — | — | — | $45 – $45 |
| 3 | Humana ppo fee schedule · both | $45 | $45 | — | — | — | $45 – $45 |
| 4 | Ambetter managed medicaid percent of total billed charges · outpatientfrom % of charges | $594 | $594 | $126 | 21% | — | $468 – $720 |
| 5 | UnitedHealthcare commercial percent of total billed charges · outpatientfrom % of charges | $794 | $794 | $168 | 21% | — | $626 – $962 |
| 6 | Anthem hmo/ppo percent of total billed charges · inpatientfrom % of charges | $866 | $866 | $184 | 21% | — | $683 – $1.1k |
| 7 | Anthem hmo/ppo percent of total billed charges · outpatientfrom % of charges | $866 | $866 | $184 | 21% | — | $683 – $1.1k |
| 8 | Ambetter managed medicaid percent of total billed charges · inpatientfrom % of charges | $1.0k | $1.0k | $214 | 21% | — | $796 – $1.2k |
| 9 | Humana hmo/pos percent of total billed charges · outpatientfrom % of charges | $1.2k | $1.2k | $247 | 21% | — | $919 – $1.4k |
| 10 | Kaiser commercial percent of total billed charges · inpatientfrom % of charges | $1.3k | $1.3k | $273 | 21% | — | $1.0k – $1.6k |
| 11 | Kaiser commercial percent of total billed charges · outpatientfrom % of charges | $1.3k | $1.3k | $273 | 21% | — | $1.0k – $1.6k |
| 12 | MultiPlan pho agreement primary network percent of total billed charges · inpatientfrom % of charges | $1.3k | $1.3k | $273 | 21% | — | $1.0k – $1.6k |
| 13 | MultiPlan pho agreement primary network percent of total billed charges · outpatientfrom % of charges | $1.3k | $1.3k | $273 | 21% | — | $1.0k – $1.6k |
| 14 | Cigna commercial percent of total billed charges · outpatientfrom % of charges | $1.3k | $1.3k | $276 | 21% | — | $1.0k – $1.6k |
| 15 | Aetna hmo percent of total billed charges · inpatientfrom % of charges | $1.3k | $1.3k | $277 | 21% | — | $1.0k – $1.6k |
| 16 | Aetna hmo percent of total billed charges · outpatientfrom % of charges | $1.3k | $1.3k | $277 | 21% | — | $1.0k – $1.6k |
| 17 | Aetna pos percent of total billed charges · inpatientfrom % of charges | $1.3k | $1.3k | $277 | 21% | — | $1.0k – $1.6k |
| 18 | Aetna pos percent of total billed charges · outpatientfrom % of charges | $1.3k | $1.3k | $277 | 21% | — | $1.0k – $1.6k |
| 19 | Cigna commercial percent of total billed charges · inpatientfrom % of charges | $1.3k | $1.3k | $277 | 21% | — | $1.0k – $1.6k |
| 20 | Humana ppo percent of total billed charges · outpatientfrom % of charges | $1.4k | $1.4k | $289 | 21% | — | $1.1k – $1.6k |
| 21 | Aetna ppo percent of total billed charges · outpatientfrom % of charges | $1.4k | $1.4k | $294 | 21% | — | $1.1k – $1.7k |
| 22 | MultiPlan pho agreement complimentary network percent of total billed charges · inpatientfrom % of charges | $1.6k | $1.6k | $336 | 21% | — | $1.2k – $1.9k |
| 23 | MultiPlan pho agreement complimentary network percent of total billed charges · outpatientfrom % of charges | $1.6k | $1.6k | $336 | 21% | — | $1.2k – $1.9k |
| 24 | Beechstreet commercial percent of total billed charges · inpatientfrom % of charges | $1.8k | $1.8k | $391 | 21% | — | $1.5k – $2.2k |
| 25 | Beechstreet commercial percent of total billed charges · outpatientfrom % of charges | $1.8k | $1.8k | $391 | 21% | — | $1.5k – $2.2k |
Last updated: Nov 19, 2025
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