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, ALLOWRAP DS, WET, 4 X 8CM
Elyria, OH
See all hospitals reporting HCPCS Q4150 →Price type
University Hospitals Health System’s median price of $4.7k is 2675% above the median hospital's median price ($170), higher than 93% of the 1,240 hospitals reporting HCPCS Q4150. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 13 payers, 42 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 medicare advantage facility · fee schedule · outpatient | $118 | $118 | — | — | — | $118 – $118 |
| 2 | Anthem medicare advantage facility · fee schedule · outpatient | $118 | $118 | — | — | — | $118 – $118 |
| 3 | Cigna medicare advantage facility · fee schedule · outpatient | $118 | $118 | — | — | — | $118 – $118 |
| 4 | Devoted medicare advantage facility · fee schedule · outpatient | $118 | $118 | — | — | — | $118 – $118 |
| 5 | Humana medicare advantage facility · fee schedule · outpatient | $118 | $118 | — | — | — | $118 – $118 |
| 6 | Medical Mutual medicare advantage facility · fee schedule · outpatient | $118 | $118 | — | — | — | $118 – $118 |
| 7 | Molina medicare advantage facility · fee schedule · outpatient | $118 | $118 | — | — | — | $118 – $118 |
| 8 | UnitedHealthcare medicare advantage facility · fee schedule · outpatient | $118 | $118 | — | — | — | $118 – $118 |
| 9 | WellCare medicare advantage facility · fee schedule · outpatient | $118 | $118 | — | — | — | $118 – $118 |
| 10 | Medical Mutual medflex commercial facility · fee schedule · outpatient | $165 | $165 | — | — | — | $165 – $165 |
| 11 | Medical Mutual supermed hmo facility · fee schedule · outpatient | $184 | $184 | — | — | — | $184 – $184 |
| 12 | Medical Mutual nas commercial facility · fee schedule · outpatient | $202 | $202 | — | — | — | $202 – $202 |
| 13 | Ambetter commercial facility · fee schedule · outpatient | $212 | $212 | — | — | — | $212 – $212 |
| 14 | Caresource marketplace facility · fee schedule · outpatient | $212 | $212 | — | — | — | $212 – $212 |
| 15 | Medical Mutual northern ohio commercial facility · percent of total billed charges · outpatientfrom % of charges | $4.5k | $4.3k | $1.8k | 42% | — | $1.9k – $6.6k |
| 16 | Medical Mutual supermed ppo facility · percent of total billed charges · outpatientfrom % of charges | $4.5k | $4.4k | $1.9k | 42% | — | $1.9k – $6.7k |
| 17 | Anthem commercial facility · percent of total billed charges · outpatientfrom % of charges | $5.4k | $5.1k | $1.9k | 37% | — | $2.4k – $7.2k |
| 18 | Anthem traditional commercial facility · percent of total billed charges · outpatientfrom % of charges | $5.4k | $5.1k | $1.9k | 37% | — | $2.4k – $7.2k |
| 19 | UnitedHealthcare nexus commercial facility · percent of total billed charges · outpatientfrom % of charges | $5.1k | $5.4k | $2.3k | 42% | — | $2.8k – $8.4k |
| 20 | Medical Mutual northern ohio commercial facility · percent of total billed charges · inpatientfrom % of charges | $6.2k | $6.0k | $2.5k | 42% | — | $2.6k – $9.1k |
| 21 | UnitedHealthcare commercial facility · percent of total billed charges · outpatientfrom % of charges | $5.7k | $6.0k | $2.6k | 42% | — | $3.1k – $9.3k |
| 22 | UnitedHealthcare commercial facility · percent of total billed charges · inpatientfrom % of charges | $6.1k | $6.1k | — | — | — | $6.1k – $6.1k |
| 23 | UnitedHealthcare nexus commercial facility · percent of total billed charges · inpatientfrom % of charges | $6.1k | $6.1k | — | — | — | $6.1k – $6.1k |
| 24 | Anthem commercial facility · percent of total billed charges · inpatientfrom % of charges | $6.4k | $6.4k | — | — | — | $6.4k – $6.4k |
| 25 | Anthem traditional commercial facility · percent of total billed charges · inpatientfrom % of charges | $6.4k | $6.4k | — | — | — | $6.4k – $6.4k |
Last updated: Jul 14, 2026
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