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
SKIN GRAFT OASIS ULTRA TRI-LAY
Hackensack, NJ
See all hospitals reporting HCPCS Q4124 →Price type
Hmh Hospitals Corporation’s median price of $20 is 82% below the median hospital's median price ($108), higher than 28% of the 1,428 hospitals reporting HCPCS Q4124. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 7 payers, 14 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 | Clover medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $6 | $6 | $0 | 2% | — | $6 – $6 |
| 2 | Optum managed medicaid facility · percent of total billed charges · outpatientfrom % of charges | $7 | $7 | $0 | 2% | — | $7 – $8 |
| 3 | Aetna medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $10 | $10 | $0 | 2% | — | $10 – $10 |
| 4 | Cigna hmo facility · percent of total billed charges · bothfrom % of charges | $11 | $11 | $0 | 2% | — | $11 – $12 |
| 5 | Cigna ppo facility · percent of total billed charges · bothfrom % of charges | $11 | $11 | $0 | 2% | — | $11 – $12 |
| 6 | Aetna asa facility · percent of total billed charges · outpatientfrom % of charges | $15 | $15 | $0 | 2% | — | $14 – $15 |
| 7 | Aetna hmo facility · percent of total billed charges · outpatientfrom % of charges | $15 | $15 | $0 | 2% | — | $14 – $15 |
| 8 | Aetna ppo facility · percent of total billed charges · outpatientfrom % of charges | $15 | $15 | $0 | 2% | — | $14 – $15 |
| 9 | WellCare managed medicaid facility · percent of total billed charges · outpatientfrom % of charges | $15 | $15 | $0 | 2% | — | $15 – $16 |
| 10 | WellCare medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $15 | $15 | $0 | 2% | — | $15 – $16 |
| 11 | Aetna managed medicaid facility · percent of total billed charges · outpatientfrom % of charges | $17 | $17 | $0 | 2% | — | $16 – $17 |
| 12 | UnitedHealthcare hmo facility · percent of total billed charges · outpatientfrom % of charges | $19 | $19 | $0 | 2% | — | $19 – $20 |
| 13 | Cigna bh facility · percent of total billed charges · outpatientfrom % of charges | $27 | $27 | $1 | 2% | — | $27 – $28 |
| 14 | MultiPlan all products facility · percent of total billed charges · bothfrom % of charges | $29 | $29 | $1 | 2% | — | $28 – $29 |
Last updated: Dec 31, 2025
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