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 TIS HMATRIX DERMIS 10X5 -COST PER SQ CM
Dublin, OH
See all hospitals reporting HCPCS Q4134 →Price type
Mount Carmel Dublin’s median price of $50 is 72% below the median hospital's median price ($178), higher than 6% of the 801 hospitals reporting HCPCS Q4134. 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, 13 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 asa meritain facility · percent of total billed charges · bothfrom % of charges | $48 | $48 | — | — | — | $48 – $48 |
| 2 | Medcost cofinity facility · percent of total billed charges · bothfrom % of charges | $50 | $50 | — | — | — | $50 – $50 |
| 3 | Aetna aetna neighborhood narrow network facility · percent of total billed charges · bothfrom % of charges | $52 | $52 | — | — | — | $52 – $52 |
| 4 | UnitedHealthcare united healthcare ppo facility · percent of total billed charges · bothfrom % of charges | $54 | $54 | — | — | — | $54 – $54 |
| 5 | Humana choice care humana facility · percent of total billed charges · bothfrom % of charges | $54 | $54 | — | — | — | $54 – $54 |
| 6 | Humana humana one facility · percent of total billed charges · bothfrom % of charges | $54 | $54 | — | — | — | $54 – $54 |
| 7 | Anthem anthem bcbs pathway grp hmo facility · percent of total billed charges · bothfrom % of charges | $55 | $55 | — | — | — | $55 – $55 |
| 8 | First Health aetna first health facility · percent of total billed charges · bothfrom % of charges | $56 | $56 | — | — | — | $56 – $56 |
| 9 | UnitedHealthcare united healthcare exchange facility · percent of total billed charges · bothfrom % of charges | $59 | $59 | — | — | — | $59 – $59 |
| 10 | Cigna cigna facility · percent of total billed charges · bothfrom % of charges | $59 | $59 | — | — | — | $59 – $59 |
| 11 | MultiPlan multiplan phcs facility · percent of total billed charges · bothfrom % of charges | $85 | $85 | — | — | — | $85 – $85 |
| 12 | Phcs multiplan phcs facility · percent of total billed charges · bothfrom % of charges | $85 | $85 | — | — | — | $85 – $85 |
| 13 | Anthem anthem bcbs blue trad facility · percent of total billed charges · bothfrom % of charges | $106 | $106 | — | — | — | $106 – $106 |
Last updated: Mar 31, 2026
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