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
MATRIX WOUND W 10CM 10CM POLYURETHANE NOVOSORB MTX SINGLE
Low
$23
Average
$61
Median
$61
High
$174
Each hospital's average Sanford Health Plan rate, under the methodology and billing class chosen below.
13 hospitals; the 90th percentile is 2.2× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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21 hospital rates
iThe hospitals that file a Sanford Health Plan rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Altru Hospital Devils Lake Devils Lake, ND facility · fee schedule · outpatient | 1 | $174 | $174 | $25 | 15% | — | $148 – $199 |
| 2 | Fairview Bethesda Hospital St. Paul, MN percent of total billed charges · inpatientfrom % of charges | 1 | $61 | $61 | — | — | — | $61 – $61 |
| 3 | Fairview Bethesda Hospital St. Paul, MN percent of total billed charges · outpatientfrom % of charges | 1 | $61 | $61 | — | — | — | $61 – $61 |
| 4 | Fairview Health Services Edina, MN percent of total billed charges · inpatientfrom % of charges | 1 | $61 | $61 | — | — | — | $61 – $61 |
| 5 | Fairview Health Services Edina, MN percent of total billed charges · outpatientfrom % of charges | 1 | $61 | $61 | — | — | — | $61 – $61 |
| 6 | Fairview Health Services Minneapolis, MN percent of total billed charges · inpatientfrom % of charges | 1 | $61 | $61 | — | — | — | $61 – $61 |
| 7 | Fairview Health Services Minneapolis, MN percent of total billed charges · outpatientfrom % of charges | 1 | $61 | $61 | — | — | — | $61 – $61 |
| 8 | Fairview Health Services Burnsville, MN percent of total billed charges · inpatientfrom % of charges | 1 | $61 | $61 | — | — | — | $61 – $61 |
| 9 | Fairview Health Services Burnsville, MN percent of total billed charges · outpatientfrom % of charges | 1 | $61 | $61 | — | — | — | $61 – $61 |
| 10 | Fairview Health Services Wyoming, MN percent of total billed charges · inpatientfrom % of charges | 1 | $61 | $61 | — | — | — | $61 – $61 |
| 11 | Fairview Health Services Wyoming, MN percent of total billed charges · outpatientfrom % of charges | 1 | $61 | $61 | — | — | — | $61 – $61 |
| 12 | Fairview Health Services Princeton, MN percent of total billed charges · inpatientfrom % of charges | 1 | $61 | $61 | — | — | — | $61 – $61 |
| 13 | Fairview Health Services Princeton, MN percent of total billed charges · outpatientfrom % of charges | 1 | $61 | $61 | — | — | — | $61 – $61 |
| 14 | HealthEast St John's Hospital Maplewood, MN percent of total billed charges · inpatientfrom % of charges | 1 | $61 | $61 | — | — | — | $61 – $61 |
| 15 | HealthEast St John's Hospital Maplewood, MN percent of total billed charges · outpatientfrom % of charges | 1 | $61 | $61 | — | — | — | $61 – $61 |
| 16 | HealthEast Woodwinds Hospital Woodbury, MN percent of total billed charges · inpatientfrom % of charges | 1 | $61 | $61 | — | — | — | $61 – $61 |
| 17 | HealthEast Woodwinds Hospital Woodbury, MN percent of total billed charges · outpatientfrom % of charges | 1 | $61 | $61 | — | — | — | $61 – $61 |
| 18 | Sanford Bemidji Medical Center Bemidji, MN percent of total billed charges · outpatientfrom % of charges | 4 | $57 | $51 | $27 | 53% | — | $13 – $91 |
| 19 | Sanford Fargo Medical Center Fargo, ND percent of total billed charges · outpatientfrom % of charges | 4 | $13 | $24 | $17 | 70% | — | $9 – $58 |
| 20 | Sanford Medical Center Bismarck Bismarck, ND percent of total billed charges · outpatientfrom % of charges | 4 | $18 | $23 | $16 | 67% | — | $8 – $52 |
| 21 | Sanford USD Medical Center Sioux Falls, SD percent of total billed charges · outpatientfrom % of charges | 4 | $22 | $42 | $33 | 77% | — | $15 – $102 |
← Payers reporting HCPCS A2006 · Snapshot 20261112T124536Z-e251e855