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
18474-0000-08 - Collagen-Antimicrobial Sheet 4 cm2
Jackson, MS
See all hospitals reporting CPT 90621 →Price type
Jackson HMA LLC’s median price of $150 is 45% below the median hospital's median price ($272), higher than 11% of the 1,386 hospitals reporting CPT 90621. 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, 17 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 bcbs ms fmp facility · other · outpatient | $0 | $49 | $70 | 141% | — | $0 – $148 |
| 2 | Tricare node tricare facility · fee schedule · outpatient | $0 | $70 | $98 | 141% | — | $0 – $209 |
| 3 | Aetna node first choice aetna mcr adv facility · fee schedule · outpatient | $100 | $100 | — | — | — | $100 – $100 |
| 4 | UnitedHealthcare uhc chip medicaid ms facility · case rate · outpatient | $150 | $150 | — | — | — | $150 – $150 |
| 5 | UnitedHealthcare uhc medicaid ms facility · case rate · outpatient | $150 | $150 | — | — | — | $150 – $150 |
| 6 | Molina molina medicaid ms facility · other · outpatient | $151 | $151 | — | — | — | $151 – $151 |
| 7 | Caresource caresource truecare facility · case rate · outpatient | $153 | $153 | — | — | — | $153 – $153 |
| 8 | Molina molina chip facility · other · outpatient | $162 | $162 | — | — | — | $162 – $162 |
| 9 | Cigna Healthspring node cigna healthspring mcr adv facility · fee schedule · outpatient | $0 | $233 | $330 | 141% | — | $0 – $700 |
| 10 | UnitedHealthcare uhc iex facility · percent of total billed charges · outpatientfrom % of charges | $259 | $259 | — | — | — | $259 – $259 |
| 11 | Cigna cigna facility · percent of total billed charges · outpatientfrom % of charges | $276 | $276 | — | — | — | $276 – $276 |
| 12 | UnitedHealthcare uhc apa facility · percent of total billed charges · outpatientfrom % of charges | $279 | $279 | — | — | — | $279 – $279 |
| 13 | UnitedHealthcare uhc options ppo facility · percent of total billed charges · inpatientfrom % of charges | $297 | $297 | — | — | — | $297 – $297 |
| 14 | UnitedHealthcare uhc options ppo facility · percent of total billed charges · outpatientfrom % of charges | $297 | $297 | — | — | — | $297 – $297 |
| 15 | Devoted node devoted health mcr adv facility · fee schedule · outpatient | $420 | $420 | — | — | — | $420 – $420 |
| 16 | Molina molina exchange facility · fee schedule · outpatient | $490 | $490 | — | — | — | $490 – $490 |
| 17 | Aetna aetna pho facility · other · outpatient | $700 | $700 | — | — | — | $700 – $700 |
Last updated: Apr 1, 2026
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