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 NovoSorb BTM 10x10cm BTM-1010
Lowell, MA
See all hospitals reporting HCPCS A4100 →Price type
Lowell General Hospital’s median price of $984 is 369% above the median hospital's median price ($210), higher than 81% of the 502 hospitals reporting HCPCS A4100. 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, 7 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 | Amerihealth Caritas hb xr non-contracted 35% of billed charges lgh percent of total billed charges · bothfrom % of charges | $735 | $968 | $355 | 37% | — | $700 – $1.5k |
| 2 | First Health hb xr non-contracted 35% of billed charges lgh percent of total billed charges · bothfrom % of charges | $735 | $968 | $355 | 37% | — | $700 – $1.5k |
| 3 | Cigna hb xr cigna lgh percent of total billed charges · bothfrom % of charges | $1.1k | $1.4k | $507 | 37% | — | $1k – $2.1k |
| 4 | UnitedHealthcare hb xr uhc lgh percent of total billed charges · bothfrom % of charges | $1.7k | $1.8k | $191 | 10% | — | $1.7k – $2.1k |
| 5 | MultiPlan hb xr claritev lgh percent of total billed charges · bothfrom % of charges | $1.7k | $2.3k | $844 | 37% | — | $1.7k – $3.5k |
| 6 | Aetna hb xr aetna hmo ppo lgh percent of total billed charges · bothfrom % of charges | $1.9k | $2.5k | $933 | 37% | — | $1.8k – $3.9k |
| 7 | Medicaid hb xr medicaid limited cmsp 100% percent of total billed charges · bothfrom % of charges | $2.1k | $2.8k | $1.0k | 37% | — | $2k – $4.2k |
Last updated: Apr 1, 2026
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