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 Clover 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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33 hospital rates
| # | Plans | |||
|---|---|---|---|---|
| 1 | Capital Health System Inc Trenton, NJ case rate · outpatient | 1 | $140.01 | $140.01 – $140.01 |
| 2 | Capital Health System Inc Browns Mills, NJ case rate · outpatient | 1 | $140.01 | $140.01 – $140.01 |
| 3 | East Cooper Medical Center LLC Mt Pleasant, SC fee schedule · outpatient | 2 | $120.37 | $120.37 – $120.37 |
| 4 | HMH HOSPITALS CORPORATION Hackensack, NJ facility · percent of total billed charges · outpatientfrom % of charges | 1 | $401.81 | $16.11 – $1,830 |
| 5 | HMH HOSPITALS CORPORATION Red Bank, NJ facility · percent of total billed charges · outpatientfrom % of charges | 1 | $401.81 | $16.11 – $1,830 |
| 6 | HMH HOSPITALS CORPORATION Edison, NJ facility · percent of total billed charges · outpatientfrom % of charges | 1 | $401.81 | $16.11 – $1,830 |
| 7 | HMH HOSPITALS CORPORATION Manahawkin, NJ facility · percent of total billed charges · outpatientfrom % of charges | 1 | $401.81 | $16.11 – $1,830 |
| 8 | HMH HOSPITALS CORPORATION Brick, NJ facility · percent of total billed charges · outpatientfrom % of charges | 1 | $401.81 | $16.11 – $1,830 |
| 9 | HMH HOSPITALS CORPORATION Neptune City, NJ facility · percent of total billed charges · outpatientfrom % of charges | 1 | $401.81 | $16.11 – $1,830 |
| 10 | HMH HOSPITALS CORPORATION Edison, NJ facility · percent of total billed charges · outpatientfrom % of charges | 1 | $401.81 | $16.11 – $1,830 |
| 11 | HMH HOSPITALS CORPORATION North Bergen, NJ facility · percent of total billed charges · outpatientfrom % of charges | 1 | $401.81 | $16.11 – $1,830 |
| 12 | HMH HOSPITALS CORPORATION Holmdel, NJ facility · percent of total billed charges · outpatientfrom % of charges | 1 | $4.02 | $0.16 – $18.30 |
| 13 | HMH HOSPITALS CORPORATION Old Bridge, NJ facility · percent of total billed charges · outpatientfrom % of charges | 1 | $401.81 | $16.11 – $1,830 |
| 14 | HMH HOSPITALS CORPORATION Point Pleasant, NJ facility · percent of total billed charges · outpatientfrom % of charges | 1 | $401.81 | $16.11 – $1,830 |
| 15 | HMH HOSPITALS CORPORATION Perth Amboy, NJ facility · percent of total billed charges · outpatientfrom % of charges | 1 | $401.81 | $16.11 – $1,830 |
| 16 | Hilton Head Medical Center LLC Hilton Head Island, SC fee schedule · outpatient | 2 | $120.37 | $120.37 – $120.37 |
| 17 | Inspira Medical Center Mullica Hill Hill, NJ fee schedule · outpatient | 1 | $140.01 | $140.01 – $140.01 |
| 18 | Inspira Medical Center Vineland Vineland, NJ fee schedule · outpatient | 1 | $140.01 | $140.01 – $140.01 |
| 19 | Kershaw Medical Center Camden, SC facility · fee schedule · outpatient | 1 | $122.70 | $122.70 – $122.70 |
| 20 | MUSC Health Black River Medical Center Cades, SC facility · fee schedule · outpatient | 1 | $118.06 | $118.06 – $118.06 |
| 21 | MUSC Health Columbia Medical Center Northeast Columbia, SC facility · fee schedule · outpatient | 1 | $122.70 | $122.70 – $122.70 |
| 22 | MUSC Medical Center Charleston, SC facility · fee schedule · outpatient | 1 | $118.06 | $118.06 – $118.06 |
| 23 | Musc Health Columbia Medical Center Downtown Columbia, SC facility · fee schedule · outpatient | 1 | $122.70 | $122.70 – $122.70 |
| 24 | Northwest Hospital LLC Tucson, AZ facility · fee schedule · outpatient | 1 | $134.12 | $134.12 – $134.12 |
| 25 | Northwest Sahurita Hospital LLC Tucson, AZ facility · fee schedule · outpatient | 1 | $134.12 | $134.12 – $134.12 |
← Payers reporting HCPCS A2007 · Snapshot 20261109T115250Z-6452cf6e