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 Cigna 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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801 hospital rates
| # | Plans | |||
|---|---|---|---|---|
| 1 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · fee schedule · outpatient | 1 | $121.27 | $121.27 – $121.27 |
| 2 | ALBANY GENERAL HOSPITAL Albany, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $1,901 | $102.60 – $16,910 |
| 3 | ALBANY GENERAL HOSPITAL Albany, OR professional · fee schedule · outpatient | 2 | $205.70 | $205.70 – $205.70 |
| 4 | ALLE-KISKI MEDICAL CENTER NATRONA HEIGHTS, PA fee schedule · inpatient | 1 | $205.70 | $205.70 – $205.70 |
| 5 | ALLE-KISKI MEDICAL CENTER NATRONA HEIGHTS, PA fee schedule · outpatient | 1 | $205.70 | $205.70 – $205.70 |
| 6 | AMH Cath Labs LLC Arlington, TX percent of total billed charges · inpatientfrom % of charges | 1 | $315.57 | $139.20 – $628.87 |
| 7 | AMH Cath Labs LLC Arlington, TX percent of total billed charges · outpatientfrom % of charges | 3 | $244.90 | $81.78 – $628.87 |
| 8 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH case rate · outpatient | 1 | $0.62 | $0.62 – $0.62 |
| 9 | Advocate Childrens Hospital Oak Lawn Oak Lawn, IL facility · fee schedule · outpatient | 1 | $411.40 | $411.40 – $411.40 |
| 10 | Advocate Childrens Hospital Park Ridge Park Ridge, IL facility · fee schedule · outpatient | 1 | $411.40 | $411.40 – $411.40 |
| 11 | Advocate Christ Medical Center Oak Lawn, IL facility · fee schedule · outpatient | 1 | $411.40 | $411.40 – $411.40 |
| 12 | Advocate Condell Medical Center Libertyville, IL fee schedule · outpatient | 1 | $411.40 | $411.40 – $411.40 |
| 13 | Advocate Good Samaritan Hospital Downers Grove, IL fee schedule · outpatient | 1 | $411.40 | $411.40 – $411.40 |
| 14 | Advocate Good Shepherd Hospital Barrington, IL fee schedule · outpatient | 1 | $411.40 | $411.40 – $411.40 |
| 15 | Advocate Illinois Masonic Medical Center Chicago, IL fee schedule · outpatient | 1 | $411.40 | $411.40 – $411.40 |
| 16 | Advocate Lutheran General Hospital Park Ridge, IL fee schedule · outpatient | 1 | $411.40 | $411.40 – $411.40 |
| 17 | Advocate Sherman Hospital Elgin, IL fee schedule · outpatient | 1 | $411.40 | $411.40 – $411.40 |
| 18 | Advocate South Suburban Hospital Hazel Crest, IL fee schedule · outpatient | 1 | $411.40 | $411.40 – $411.40 |
| 19 | Advocate Trinity Hospital Chicago, IL fee schedule · outpatient | 1 | $411.40 | $411.40 – $411.40 |
| 20 | Alleghany County Memorial Hospital, Inc Sparta, NC facility · percent of total billed charges · inpatientfrom % of charges | 1 | $1,710 | $48.72 – $3,444 |
| 21 | Alleghany County Memorial Hospital, Inc Sparta, NC facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1,710 | $48.72 – $3,444 |
| 22 | Allen Memorial Hospital Corporation Waterloo, IA fee schedule · both | 1 | $193.54 | $193.54 – $193.54 |
| 23 | Allen Memorial Hospital Corporation Waterloo, IA percent of total billed charges · inpatientfrom % of charges | 1 | $362.45 | $362.45 – $362.45 |
| 24 | Allen Memorial Hospital Corporation Waterloo, IA percent of total billed charges · outpatientfrom % of charges | 1 | $362.45 | $362.45 – $362.45 |
| 25 | Alton Memorial Hospital Alton, IL fee schedule · both | 3 | $369.16 | $339.41 – $384.04 |
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