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 SKIN THICK 40X30MM 12SQCM -COST PER SQ CM
Dublin, OH
See all hospitals reporting HCPCS Q4125 →Price type
Mount Carmel Dublin’s median price of $248 is 59% below the median hospital's median price ($603), higher than 33% of the 1,317 hospitals reporting HCPCS Q4125. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 13 payers, 20 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 | Aetna aetna medicare advantage facility · percent of total billed charges · bothfrom % of charges | $107 | $104 | $47 | 45% | — | $6 – $197 |
| 2 | Molina molina medicare advantage facility · percent of total billed charges · bothfrom % of charges | $173 | $167 | $75 | 45% | — | $10 – $317 |
| 3 | Medical Mutual medical mutual medflex facility · percent of total billed charges · bothfrom % of charges | $229 | $221 | $99 | 45% | — | $14 – $419 |
| 4 | Medical Mutual medical mutual supermed ppo pos hmo facility · percent of total billed charges · bothfrom % of charges | $238 | $230 | $104 | 45% | — | $14 – $437 |
| 5 | Anthem anthem bcbs pathway grp hmo facility · percent of total billed charges · bothfrom % of charges | $257 | $249 | $112 | 45% | — | $15 – $472 |
| 6 | Aetna aetna neighborhood narrow network facility · percent of total billed charges · bothfrom % of charges | $247 | $407 | $676 | 166% | — | $15 – $3.0k |
| 7 | Oscar oscar facility · percent of total billed charges · bothfrom % of charges | $302 | $463 | $694 | 150% | — | $18 – $3.1k |
| 8 | Aetna aetna asa meritain facility · percent of total billed charges · bothfrom % of charges | $226 | $502 | $1.1k | 222% | — | $13 – $4.8k |
| 9 | Medcost cofinity facility · percent of total billed charges · bothfrom % of charges | $235 | $522 | $1.2k | 222% | — | $14 – $5.0k |
| 10 | UnitedHealthcare united healthcare ppo facility · percent of total billed charges · bothfrom % of charges | $255 | $566 | $1.3k | 222% | — | $15 – $5.4k |
| 11 | Humana choice care humana facility · percent of total billed charges · bothfrom % of charges | $257 | $572 | $1.3k | 222% | — | $15 – $5.5k |
| 12 | Humana humana one facility · percent of total billed charges · bothfrom % of charges | $257 | $572 | $1.3k | 222% | — | $15 – $5.5k |
| 13 | First Health aetna first health facility · percent of total billed charges · bothfrom % of charges | $265 | $589 | $1.3k | 222% | — | $16 – $5.6k |
| 14 | UnitedHealthcare united healthcare exchange facility · percent of total billed charges · bothfrom % of charges | $278 | $618 | $1.4k | 222% | — | $16 – $5.9k |
| 15 | Cigna cigna facility · percent of total billed charges · bothfrom % of charges | $282 | $627 | $1.4k | 222% | — | $17 – $6.0k |
| 16 | MultiPlan multiplan phcs facility · percent of total billed charges · bothfrom % of charges | $402 | $893 | $2.0k | 222% | — | $24 – $8.6k |
| 17 | Phcs multiplan phcs facility · percent of total billed charges · bothfrom % of charges | $402 | $893 | $2.0k | 222% | — | $24 – $8.6k |
| 18 | Amerihealth Caritas amerihealth caritas medicaid facility · percent of total billed charges · bothfrom % of charges | $504 | $1.1k | $2.5k | 222% | — | $30 – $10.7k |
| 19 | Anthem anthem bcbs blue trad facility · percent of total billed charges · bothfrom % of charges | $504 | $1.1k | $2.5k | 222% | — | $30 – $10.7k |
| 20 | Humana humana medicaid facility · percent of total billed charges · bothfrom % of charges | $504 | $1.1k | $2.5k | 222% | — | $30 – $10.7k |
Last updated: Mar 31, 2026
See Donor skin tissue graft (Arthroflex) 5x20x30mm pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.