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 2.5x3cm 2mm Thickness <8 Sq Cm>
McCall, ID
See all hospitals reporting HCPCS Q4125 →Price type
St Luke's McCall, LTD’s median price of $259 is 57% below the median hospital's median price ($603), higher than 35% of the 1,317 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: 8 payers, 12 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 | Molina hb mccall molina mmcp percent of total billed charges · bothfrom % of charges | $253 | $216 | $56 | 26% | — | $137 – $259 |
| 2 | Regence hb mccall medicare advantage percent of total billed charges · bothfrom % of charges | $253 | $216 | $56 | 26% | — | $137 – $259 |
| 3 | Blue Cross Blue Shield hb mccall bci true & secure med adv percent of total billed charges · bothfrom % of charges | $255 | $218 | $57 | 26% | — | $138 – $261 |
| 4 | Molina hb mccall molina med adv percent of total billed charges · bothfrom % of charges | $258 | $220 | $57 | 26% | — | $140 – $264 |
| 5 | Aetna hb mccall aetna med adv percent of total billed charges · bothfrom % of charges | $278 | $238 | $62 | 26% | — | $151 – $285 |
| 6 | Bcbs Id hb mccall bci percent of total billed charges · inpatientfrom % of charges | $384 | $328 | $85 | 26% | — | $208 – $392 |
| 7 | Blue Cross Blue Shield hb mccall bci percent of total billed charges · inpatientfrom % of charges | $384 | $328 | $85 | 26% | — | $208 – $392 |
| 8 | Aetna hb mccall aetna trinity health (st al's) percent of total billed charges · bothfrom % of charges | $392 | $335 | $87 | 26% | — | $212 – $401 |
| 9 | Cigna hb mccall cigna percent of total billed charges · bothfrom % of charges | $405 | $347 | $90 | 26% | — | $219 – $415 |
| 10 | Aetna hb mccall bp aetna percent of total billed charges · bothfrom % of charges | $414 | $354 | $92 | 26% | — | $224 – $424 |
| 11 | First Health hb mccall first choice health percent of total billed charges · bothfrom % of charges | $414 | $354 | $92 | 26% | — | $224 – $424 |
| 12 | UnitedHealthcare hb mccall united healthcare percent of total billed charges · bothfrom % of charges | $419 | $358 | $93 | 26% | — | $227 – $428 |
Last updated: Mar 25, 2026
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.