Integra or Omnigraft dermal regeneration template at Holy Cross Hospital-Silver Spring

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-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

KIT OMNIGRAFT 2.5X2.5CM DERMAL REGENERATION MATRIX - Q4105-COST PER SQ CM

Silver Spring, MD

See all hospitals reporting HCPCS Q4105 →

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Pricing by billing methodology

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How this price compares nationally

Holy Cross Hospital-Silver Spring’s median price of $182 is 44% above the median hospital's median price ($127), higher than 75% of the 1,338 hospitals reporting HCPCS Q4105. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS Q4105 at Holy Cross Hospital-Silver Spring

Negotiated rates from the hospital’s own file: 15 payers, 26 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 healthspring medicare advantage facility · percent of total billed charges · bothfrom % of charges	$174	$174	$43	25%	—	$131 – $217
2	Aetna aetna medicare advantage facility · percent of total billed charges · bothfrom % of charges	$178	$178	$44	25%	—	$134 – $222
3	Humana humana medicare advantage facility · percent of total billed charges · bothfrom % of charges	$178	$178	$44	25%	—	$134 – $222
4	Kaiser kaiser medicare advantage facility · percent of total billed charges · bothfrom % of charges	$178	$178	$44	25%	—	$134 – $222
5	Kaiser kaiser medicaid facility · percent of total billed charges · bothfrom % of charges	$179	$179	$44	25%	—	$135 – $223
6	UnitedHealthcare united healthcare medicaid facility · percent of total billed charges · bothfrom % of charges	$179	$179	$44	25%	—	$135 – $223
7	Carefirst care first bcbs medicaid facility · percent of total billed charges · bothfrom % of charges	$181	$181	$45	25%	—	$137 – $226
8	UnitedHealthcare united healthcare medicare advantage facility · percent of total billed charges · bothfrom % of charges	$182	$182	$45	25%	—	$137 – $227
9	Aetna aetna better health medicaid facility · percent of total billed charges · bothfrom % of charges	$183	$183	$45	25%	—	$138 – $228
10	Amerihealth Caritas amerihealth caritas medicaid facility · percent of total billed charges · bothfrom % of charges	$186	$186	$46	25%	—	$140 – $232
11	Aetna aetna facility · percent of total billed charges · bothfrom % of charges	$193	$193	$47	25%	—	$146 – $241
12	Anthem care first bcbs facility · percent of total billed charges · bothfrom % of charges	$193	$193	$47	25%	—	$146 – $241
13	Blue Cross Blue Shield care first bcbs facility · percent of total billed charges · bothfrom % of charges	$193	$193	$47	25%	—	$146 – $241
14	Carefirst care first bcbs facility · percent of total billed charges · bothfrom % of charges	$193	$193	$47	25%	—	$146 – $241
15	Cigna cigna facility · percent of total billed charges · bothfrom % of charges	$193	$193	$47	25%	—	$146 – $241
16	Excellus care first bcbs facility · percent of total billed charges · bothfrom % of charges	$193	$193	$47	25%	—	$146 – $241
17	Highmark care first bcbs facility · percent of total billed charges · bothfrom % of charges	$193	$193	$47	25%	—	$146 – $241
18	Kaiser kaiser facility · percent of total billed charges · bothfrom % of charges	$193	$193	$47	25%	—	$146 – $241
19	Premera care first bcbs facility · percent of total billed charges · bothfrom % of charges	$193	$193	$47	25%	—	$146 – $241
20	Regence care first bcbs facility · percent of total billed charges · bothfrom % of charges	$193	$193	$47	25%	—	$146 – $241
21	UnitedHealthcare united healthcare facility · percent of total billed charges · bothfrom % of charges	$193	$193	$47	25%	—	$146 – $241
22	Wellmark care first bcbs facility · percent of total billed charges · bothfrom % of charges	$193	$193	$47	25%	—	$146 – $241
23	Carefirst care first network leasing facility · percent of total billed charges · bothfrom % of charges	$195	$195	$48	25%	—	$147 – $243
24	Humana humana facility · percent of total billed charges · bothfrom % of charges	$195	$195	$48	25%	—	$147 – $243
25	Humana humana military facility · percent of total billed charges · bothfrom % of charges	$195	$195	$48	25%	—	$147 – $243

Page 1 of 2 · 26 rates

Last updated: Mar 31, 2026

Compare to other hospitals

See Integra or Omnigraft dermal regeneration template pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.