Human dermal matrix graft at Mount Carmel Dublin

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

TISSUE FLEX HD THCK 8X16CM -COST PER SQ CM

Dublin, OH

See all hospitals reporting HCPCS Q4128 →

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Pricing by billing methodology

Price type

How this price compares nationally

Mount Carmel Dublin’s median price of $64 is 52% below the median hospital's median price ($133), higher than 25% of the 1,532 hospitals reporting HCPCS Q4128. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS Q4128 at Mount Carmel Dublin

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	$26	$29	$13	44%	—	$5 – $63
2	Molina molina medicare advantage facility · percent of total billed charges · bothfrom % of charges	$42	$46	$20	44%	—	$8 – $102
3	Aetna aetna asa meritain facility · percent of total billed charges · bothfrom % of charges	$54	$60	$26	44%	—	$10 – $131
4	Medical Mutual medical mutual medflex facility · percent of total billed charges · bothfrom % of charges	$55	$61	$27	44%	—	$11 – $135
5	Medcost cofinity facility · percent of total billed charges · bothfrom % of charges	$56	$62	$27	44%	—	$11 – $136
6	Medical Mutual medical mutual supermed ppo pos hmo facility · percent of total billed charges · bothfrom % of charges	$57	$64	$28	44%	—	$11 – $140
7	Aetna aetna neighborhood narrow network facility · percent of total billed charges · bothfrom % of charges	$59	$65	$29	44%	—	$11 – $143
8	UnitedHealthcare united healthcare ppo facility · percent of total billed charges · bothfrom % of charges	$60	$67	$29	44%	—	$12 – $147
9	Humana choice care humana facility · percent of total billed charges · bothfrom % of charges	$61	$68	$30	44%	—	$12 – $149
10	Humana humana one facility · percent of total billed charges · bothfrom % of charges	$61	$68	$30	44%	—	$12 – $149
11	Anthem anthem bcbs pathway grp hmo facility · percent of total billed charges · bothfrom % of charges	$62	$69	$30	44%	—	$12 – $151
12	First Health aetna first health facility · percent of total billed charges · bothfrom % of charges	$63	$70	$31	44%	—	$12 – $153
13	UnitedHealthcare united healthcare exchange facility · percent of total billed charges · bothfrom % of charges	$66	$73	$32	44%	—	$13 – $161
14	Cigna cigna facility · percent of total billed charges · bothfrom % of charges	$67	$74	$33	44%	—	$13 – $163
15	Oscar oscar facility · percent of total billed charges · bothfrom % of charges	$72	$80	$35	44%	—	$14 – $175
16	MultiPlan multiplan phcs facility · percent of total billed charges · bothfrom % of charges	$95	$106	$46	44%	—	$18 – $233
17	Phcs multiplan phcs facility · percent of total billed charges · bothfrom % of charges	$95	$106	$46	44%	—	$18 – $233
18	Amerihealth Caritas amerihealth caritas medicaid facility · percent of total billed charges · bothfrom % of charges	$119	$133	$58	44%	—	$23 – $291
19	Anthem anthem bcbs blue trad facility · percent of total billed charges · bothfrom % of charges	$119	$133	$58	44%	—	$23 – $291
20	Humana humana medicaid facility · percent of total billed charges · bothfrom % of charges	$119	$133	$58	44%	—	$23 – $291

Last updated: Mar 31, 2026

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