Donor skin tissue graft (Arthroflex) 5x20x30mm at Heritage Valley Beaver

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.

Model: claude-sonnet-5-5
Provider: anthropic
API: message_batches
Reasoning effort: model default
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

DECELLURIZED DERMIS 30MM X 40MM X 0.5MM

BEAVER, PA

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Pricing by billing methodology

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How this price compares nationally

Heritage Valley Beaver’s median price of $121 is 80% below the median hospital's median price ($603), higher than 9% of the 1,317 hospitals reporting HCPCS Q4125. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS Q4125 at Heritage Valley Beaver

Negotiated rates from the hospital’s own file: 4 payers, 15 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	Cigna cigna healthcare percent of total billed charges · bothfrom % of charges	$71	$79	$34	43%	—	$37 – $128
2	Highmark blue cross freedom blue medicare fee schedule · both	$106	$106	—	—	—	$106 – $106
3	UnitedHealthcare united healthcare all payer other · both	$101	$113	$48	43%	—	$52 – $182
4	Highmark blue cross community blue medicare (28) fee schedule · both	$114	$114	—	—	—	$114 – $114
5	Highmark blue cross complete medicare fee schedule · both	$114	$114	—	—	—	$114 – $114
6	Highmark blue cross my direct blue (2u) fee schedule · both	$115	$115	—	—	—	$115 – $115
7	Cigna cigna medicare fee schedule · both	$121	$121	$1	1%	—	$118 – $121
8	Aetna aetna medicare fee schedule · both	$121	$121	—	—	—	$121 – $121
9	UnitedHealthcare united healthcare medicare fee schedule · both	$121	$121	—	—	—	$121 – $121
10	Highmark blue cross security blue medicare fee schedule · both	$129	$129	—	—	—	$129 – $129
11	Aetna aetna health percent of total billed charges · bothfrom % of charges	$107	$131	$59	45%	—	$65 – $226
12	Highmark blue cross managed care chip (81 & 12) fee schedule · both	$140	$135	$9	7%	—	$118 – $140
13	Highmark blue cross connect blue epo (86) fee schedule · both	$187	$169	$28	17%	—	$118 – $187
14	Highmark blue cross community blue (28) fee schedule · both	$227	$192	$44	23%	—	$118 – $227
15	Highmark blue cross commercial (20) fee schedule · both	$228	$196	$47	24%	—	$118 – $234

Last updated: Mar 27, 2026

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