Integra or Omnigraft dermal regeneration template at Mount Carmel East

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

KIT OMNIGRAFT 2.5X2.5CM DERMAL REGENERATION MATRIX - Q4105-COST PER SQ CM

Columbus, OH

See all hospitals reporting HCPCS Q4105 →

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Pricing by billing methodology

Price type

How this price compares nationally

Mount Carmel East’s median price of $200 is 58% above the median hospital's median price ($127), higher than 77% of the 1,343 hospitals reporting HCPCS Q4105. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS Q4105 at Mount Carmel East

Negotiated rates from the hospital’s own file: 21 payers, 32 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	$74	$74	$19	26%	—	$54 – $93
2	Molina molina medicare advantage facility · percent of total billed charges · bothfrom % of charges	$119	$119	$31	26%	—	$88 – $150
3	Anthem anthem bcbs pathway hmo facility · percent of total billed charges · bothfrom % of charges	$126	$126	$33	26%	—	$93 – $159
4	Aetna aetna asa meritain facility · percent of total billed charges · bothfrom % of charges	$152	$152	$40	26%	—	$112 – $192
5	Medical Mutual medical mutual medflex facility · percent of total billed charges · bothfrom % of charges	$157	$157	$41	26%	—	$116 – $197
6	Medical Mutual medical mutual oh supermed ppo pos hmo facility · percent of total billed charges · bothfrom % of charges	$157	$157	$41	26%	—	$116 – $197
7	Medcost cofinity facility · percent of total billed charges · bothfrom % of charges	$158	$158	$41	26%	—	$117 – $200
8	Aetna aetna neighborhood narrow network facility · percent of total billed charges · bothfrom % of charges	$166	$166	$44	26%	—	$123 – $210
9	UnitedHealthcare united healthcare ppo facility · percent of total billed charges · bothfrom % of charges	$171	$171	$45	26%	—	$127 – $216
10	Humana choice care humana facility · percent of total billed charges · bothfrom % of charges	$173	$173	$45	26%	—	$128 – $219
11	Humana humana one facility · percent of total billed charges · bothfrom % of charges	$173	$173	$45	26%	—	$128 – $219
12	Anthem anthem bcbs pathway grp hmo facility · percent of total billed charges · bothfrom % of charges	$176	$176	$46	26%	—	$130 – $222
13	First Health aetna first health facility · percent of total billed charges · bothfrom % of charges	$179	$179	$47	26%	—	$132 – $225
14	UnitedHealthcare united healthcare exchange facility · percent of total billed charges · bothfrom % of charges	$187	$187	$49	26%	—	$138 – $236
15	Cigna cigna facility · percent of total billed charges · bothfrom % of charges	$190	$190	$50	26%	—	$140 – $240
16	Anthem anthem blue access ppo blue pref hmo facility · percent of total billed charges · bothfrom % of charges	$202	$202	$53	26%	—	$149 – $255
17	Blue Cross Blue Shield anthem blue access ppo blue pref hmo facility · percent of total billed charges · bothfrom % of charges	$202	$202	$53	26%	—	$149 – $255
18	Carefirst anthem blue access ppo blue pref hmo facility · percent of total billed charges · bothfrom % of charges	$202	$202	$53	26%	—	$149 – $255
19	Excellus anthem blue access ppo blue pref hmo facility · percent of total billed charges · bothfrom % of charges	$202	$202	$53	26%	—	$149 – $255
20	Highmark anthem blue access ppo blue pref hmo facility · percent of total billed charges · bothfrom % of charges	$202	$202	$53	26%	—	$149 – $255
21	Premera anthem blue access ppo blue pref hmo facility · percent of total billed charges · bothfrom % of charges	$202	$202	$53	26%	—	$149 – $255
22	Regence anthem blue access ppo blue pref hmo facility · percent of total billed charges · bothfrom % of charges	$202	$202	$53	26%	—	$149 – $255
23	Wellmark anthem blue access ppo blue pref hmo facility · percent of total billed charges · bothfrom % of charges	$202	$202	$53	26%	—	$149 – $255
24	Oscar oscar facility · percent of total billed charges · bothfrom % of charges	$203	$203	$53	26%	—	$150 – $256
25	Caresource caresource marketplace facility · percent of total billed charges · bothfrom % of charges	$247	$247	$65	26%	—	$183 – $312

Page 1 of 2 · 32 rates

Last updated: Mar 31, 2026

Compare to other hospitals

See Integra or Omnigraft dermal regeneration template pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.