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 12.5X10CM 125SQ CM RESTRATA SOFT NONFRIABLE ABSORBABLE WOUND STERILE LATEX FREE WHITE
The hospitals that file a Aetna 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.
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939 hospital rates
| # | Plans | |||
|---|---|---|---|---|
| 1 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · fee schedule · outpatient | 3 | $366.75 | $117.73 – $551.76 |
| 2 | ALBANY GENERAL HOSPITAL Albany, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $1,901 | $102.60 – $16,910 |
| 3 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY facility · percent of total billed charges · outpatientfrom % of charges | 2 | $2,718 | $693.00 – $8,504 |
| 4 | AMH Cath Labs LLC Arlington, TX percent of total billed charges · inpatientfrom % of charges | 2 | $135.28 | $51.15 – $308.09 |
| 5 | AMH Cath Labs LLC Arlington, TX percent of total billed charges · outpatientfrom % of charges | 5 | $164.86 | $14.48 – $468.48 |
| 6 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH per diem · inpatient | 1 | $5,388 | $5,388 – $5,388 |
| 7 | Acadia Hospital Bangor, ME professional · fee schedule · outpatient | 1 | $205.70 | $205.70 – $205.70 |
| 8 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 1 | $118.83 | $118.83 – $118.83 |
| 9 | Adventhealth Port Charlotte Port Charlotte, FL fee schedule · outpatient | 1 | $135.15 | $135.15 – $135.15 |
| 10 | Alleghany County Memorial Hospital, Inc Sparta, NC facility · percent of total billed charges · outpatientfrom % of charges | 1 | $692.27 | $19.72 – $1,394 |
| 11 | Allen Memorial Hospital Corporation Waterloo, IA percent of total billed charges · outpatientfrom % of charges | 2 | $280.10 | $280.10 – $280.10 |
| 12 | Alomere Health Alexandria, MN facility · fee schedule · outpatient | 1 | $128.44 | $128.44 – $128.44 |
| 13 | Alta Newport Hospital, LLC Tustin, CA facility · case rate · outpatient | 2 | $499.95 | $499.94 – $499.96 |
| 14 | Alton Memorial Hospital Alton, IL fee schedule · both | 1 | $319.44 | $319.44 – $319.44 |
| 15 | Alton Memorial Hospital Alton, IL other · both | 2 | $133.36 | $133.36 – $133.36 |
| 16 | Alton Memorial Hospital Alton, IL percent of total billed charges · bothfrom % of charges | 3 | $0.01 | $0.01 – $0.01 |
| 17 | Altru Hospital Devils Lake Devils Lake, ND facility · fee schedule · outpatient | 2 | $163.16 | $127.14 – $228.85 |
| 18 | Aspirus Divine Savior Hospital Portage, WI fee schedule · outpatient | 1 | $120.88 | $120.88 – $120.88 |
| 19 | Aspirus Rhinelander Hospital Rhinelander, WI fee schedule · outpatient | 1 | $120.88 | $120.88 – $120.88 |
| 20 | Aspirus St. Luke’s Hospital Duluth, MN fee schedule · outpatient | 1 | $132.71 | $132.71 – $132.71 |
| 21 | Aspirus Stevens Point Hospital Stevens Point, WI fee schedule · outpatient | 1 | $120.88 | $120.88 – $120.88 |
| 22 | Aspirus Wausau Hospital Wausau, WI fee schedule · outpatient | 1 | $121.42 | $121.42 – $121.42 |
| 23 | Aspirus Wisconsin Rapids Hospital Wisconsin Rapids, WI fee schedule · outpatient | 1 | $120.88 | $120.88 – $120.88 |
| 24 | Athens Hospital, LLC Athens, TX facility · percent of total billed charges · bothfrom % of charges | 2 | $872.50 | $199.70 – $1,790 |
| 25 | Atrium Health Hospitals Inc Kings Mountain, NC percent of total billed charges · inpatientfrom % of charges | 5 | $989.54 | $17.57 – $3,157 |
← Payers reporting HCPCS A2007 · Snapshot 20261109T115250Z-6452cf6e