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
HC Graft Aflex301 7.0 X 4.0 28 Sq Cm
O'Fallon, MO
See all hospitals reporting HCPCS Q4125 →Price type
Progress West Hospital’s median price of $272 is 55% below the median hospital's median price ($606), higher than 36% of the 1,310 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: 12 payers, 27 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 bjc hb medicare advantra pwc other · both | $125 | $125 | — | — | — | $125 – $125 |
| 2 | Aetna bjc hb medicare gold advantage pwc other · both | $125 | $125 | — | — | — | $125 – $125 |
| 3 | Blue Cross Blue Shield bjc hb medicare anthem advantage pwc other · both | $125 | $125 | — | — | — | $125 – $125 |
| 4 | Humana bjc hb medicare humana pwc other · both | $125 | $125 | — | — | — | $125 – $125 |
| 5 | UnitedHealthcare bjc hb medicare uhc pwc other · both | $125 | $125 | — | — | — | $125 – $125 |
| 6 | Devoted bjc hb medicare devoted pwc other · both | $131 | $131 | — | — | — | $131 – $131 |
| 7 | Medica bjc hb medicare wellfirst pwc other · both | $131 | $131 | — | — | — | $131 – $131 |
| 8 | Cigna bjc hb cigna hmo/ppo community percent of total billed charges · bothfrom % of charges | $245 | $253 | $67 | 26% | — | $175 – $338 |
| 9 | Cigna bjc hb cigna local plus community percent of total billed charges · bothfrom % of charges | $245 | $253 | $67 | 26% | — | $175 – $338 |
| 10 | Cigna bjc hb cigna special community percent of total billed charges · bothfrom % of charges | $245 | $253 | $67 | 26% | — | $175 – $338 |
| 11 | Humana bjc hb humana choicecare community percent of total billed charges · bothfrom % of charges | $262 | $270 | $71 | 26% | — | $187 – $362 |
| 12 | Blue Cross Blue Shield bjc hb anthem choice community percent of total billed charges · bothfrom % of charges | $308 | $318 | $84 | 26% | — | $220 – $425 |
| 13 | Blue Cross Blue Shield bjc hb anthem access community percent of total billed charges · bothfrom % of charges | $312 | $321 | $85 | 26% | — | $223 – $430 |
| 14 | Aetna bjc hb aetna national percent of total billed charges · bothfrom % of charges | $350 | $361 | $95 | 26% | — | $251 – $483 |
| 15 | Aetna bjc hb first health percent of total billed charges · bothfrom % of charges | $350 | $361 | $95 | 26% | — | $251 – $483 |
| 16 | First Health bjc hb first health percent of total billed charges · bothfrom % of charges | $350 | $361 | $95 | 26% | — | $251 – $483 |
| 17 | UnitedHealthcare bjc hb first health percent of total billed charges · bothfrom % of charges | $350 | $361 | $95 | 26% | — | $251 – $483 |
| 18 | Aetna bjc hb group health plan ppo select percent of total billed charges · bothfrom % of charges | $354 | $365 | $96 | 26% | — | $253 – $488 |
| 19 | Beechstreet bjc hb multiplan percent of total billed charges · bothfrom % of charges | $354 | $365 | $96 | 26% | — | $253 – $488 |
| 20 | MultiPlan bjc hb multiplan percent of total billed charges · bothfrom % of charges | $354 | $365 | $96 | 26% | — | $253 – $488 |
| 21 | Phcs bjc hb phcs community percent of total billed charges · bothfrom % of charges | $354 | $365 | $96 | 26% | — | $253 – $488 |
| 22 | Medica bjc hb wellfirst first health community percent of total billed charges · bothfrom % of charges | $377 | $389 | $103 | 26% | — | $270 – $520 |
| 23 | Phcs bjc hb wellfirst first health community percent of total billed charges · bothfrom % of charges | $377 | $389 | $103 | 26% | — | $270 – $520 |
| 24 | Blue Cross Blue Shield bjc hb anthem alliance epo percent of total billed charges · bothfrom % of charges | $401 | $413 | $109 | 26% | — | $287 – $553 |
| 25 | Blue Cross Blue Shield bjc hb anthem blue preferred percent of total billed charges · bothfrom % of charges | $401 | $413 | $109 | 26% | — | $287 – $553 |
Last updated: Dec 15, 2025
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.