Amniotic tissue wound graft, per square centimeter 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-sonnet-5-5
Provider: anthropic
API: message_batches
Reasoning effort: model default
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

MEMBRANE AMNIOBAND 4X6CM 24SQCM -COST PER SQ CM

Dublin, OH

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Pricing by billing methodology

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How this price compares nationally

Mount Carmel Dublin’s median price of $280 is 45% above the median hospital's median price ($193), higher than 71% of the 1,304 hospitals reporting HCPCS Q4151. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS Q4151 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	$124	$125	$24	20%	—	$88 – $166
2	Molina molina medicare advantage facility · percent of total billed charges · bothfrom % of charges	$199	$201	$39	20%	—	$142 – $268
3	Aetna aetna asa meritain facility · percent of total billed charges · bothfrom % of charges	$256	$258	$50	20%	—	$182 – $344
4	Medical Mutual medical mutual medflex facility · percent of total billed charges · bothfrom % of charges	$263	$265	$52	20%	—	$187 – $354
5	Medcost cofinity facility · percent of total billed charges · bothfrom % of charges	$266	$268	$52	20%	—	$189 – $358
6	Medical Mutual medical mutual supermed ppo pos hmo facility · percent of total billed charges · bothfrom % of charges	$274	$276	$54	20%	—	$195 – $369
7	Aetna aetna neighborhood narrow network facility · percent of total billed charges · bothfrom % of charges	$280	$282	$55	20%	—	$199 – $377
8	UnitedHealthcare united healthcare ppo facility · percent of total billed charges · bothfrom % of charges	$288	$290	$57	20%	—	$205 – $388
9	Humana choice care humana facility · percent of total billed charges · bothfrom % of charges	$291	$294	$57	20%	—	$207 – $392
10	Humana humana one facility · percent of total billed charges · bothfrom % of charges	$291	$294	$57	20%	—	$207 – $392
11	Anthem anthem bcbs pathway grp hmo facility · percent of total billed charges · bothfrom % of charges	$296	$299	$58	20%	—	$210 – $399
12	First Health aetna first health facility · percent of total billed charges · bothfrom % of charges	$300	$303	$59	20%	—	$213 – $404
13	UnitedHealthcare united healthcare exchange facility · percent of total billed charges · bothfrom % of charges	$315	$317	$62	20%	—	$224 – $424
14	Cigna cigna facility · percent of total billed charges · bothfrom % of charges	$319	$322	$63	20%	—	$227 – $430
15	Oscar oscar facility · percent of total billed charges · bothfrom % of charges	$342	$344	$67	20%	—	$243 – $460
16	MultiPlan multiplan phcs facility · percent of total billed charges · bothfrom % of charges	$455	$459	$90	20%	—	$323 – $613
17	Phcs multiplan phcs facility · percent of total billed charges · bothfrom % of charges	$455	$459	$90	20%	—	$323 – $613
18	Amerihealth Caritas amerihealth caritas medicaid facility · percent of total billed charges · bothfrom % of charges	$569	$574	$112	20%	—	$405 – $767
19	Anthem anthem bcbs blue trad facility · percent of total billed charges · bothfrom % of charges	$569	$574	$112	20%	—	$405 – $767
20	Humana humana medicaid facility · percent of total billed charges · bothfrom % of charges	$569	$574	$112	20%	—	$405 – $767

Last updated: Mar 31, 2026

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