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 First Health 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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283 hospital rates
| # | Plans | |||
|---|---|---|---|---|
| 1 | Alton Memorial Hospital Alton, IL percent of total billed charges · bothfrom % of charges | 1 | $0.01 | $0.01 – $0.01 |
| 2 | Atrium Health Hospitals Inc Kings Mountain, NC percent of total billed charges · inpatientfrom % of charges | 1 | $1,731 | $49.30 – $3,485 |
| 3 | Atrium Health Hospitals Inc Kings Mountain, NC percent of total billed charges · outpatientfrom % of charges | 1 | $1,731 | $49.30 – $3,485 |
| 4 | Atrium Health Hospitals Inc Lincolnton, NC percent of total billed charges · inpatientfrom % of charges | 1 | $1,731 | $49.30 – $3,485 |
| 5 | Atrium Health Hospitals Inc Lincolnton, NC percent of total billed charges · outpatientfrom % of charges | 1 | $1,731 | $49.30 – $3,485 |
| 6 | Atrium Health Hospitals Inc Wadesboro, NC percent of total billed charges · inpatientfrom % of charges | 1 | $1,832 | $52.20 – $3,690 |
| 7 | Atrium Health Hospitals Inc Wadesboro, NC percent of total billed charges · outpatientfrom % of charges | 1 | $1,832 | $52.20 – $3,690 |
| 8 | Banner Wyoming Medical Center Casper, WY facility · percent of total billed charges · inpatientfrom % of charges | 1 | $286.90 | $107.42 – $466.37 |
| 9 | Banner Wyoming Medical Center Casper, WY facility · percent of total billed charges · outpatientfrom % of charges | 1 | $286.90 | $107.42 – $466.37 |
| 10 | Barnes Jewish Hospital St. Louis, MO percent of total billed charges · bothfrom % of charges | 1 | $204.74 | $0.01 – $406.93 |
| 11 | Bartow Regional Medical Center Bartow, FL facility · percent of total billed charges · inpatientfrom % of charges | 1 | $6,603 | $3,232 – $9,564 |
| 12 | Bartow Regional Medical Center Bartow, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $6,603 | $3,232 – $9,564 |
| 13 | BayCare Alliant Hospital Dunedin, FL facility · percent of total billed charges · inpatientfrom % of charges | 1 | $6,603 | $3,232 – $9,564 |
| 14 | BayCare Alliant Hospital Dunedin, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $6,603 | $3,232 – $9,564 |
| 15 | Baycare Hospital Wesley Chapel Chapel, FL facility · percent of total billed charges · inpatientfrom % of charges | 1 | $6,603 | $3,232 – $9,564 |
| 16 | Baycare Hospital Wesley Chapel Chapel, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $6,603 | $3,232 – $9,564 |
| 17 | Bexar County Hospital District San Antonio, TX percent of total billed charges · inpatientfrom % of charges | 1 | $2,751 | $41.00 – $13,951 |
| 18 | Bexar County Hospital District San Antonio, TX percent of total billed charges · outpatientfrom % of charges | 1 | $3,265 | $46.74 – $17,133 |
| 19 | Broaddus Hospital Association Inc Philippi, WV professional · fee schedule · both | 1 | $226.27 | $226.27 – $226.27 |
| 20 | Carolinas Medical Center Charlotte, NC percent of total billed charges · inpatientfrom % of charges | 1 | $1,629 | $46.40 – $3,280 |
| 21 | Carolinas Medical Center Charlotte, NC percent of total billed charges · outpatientfrom % of charges | 1 | $1,690 | $48.14 – $3,403 |
| 22 | Carolinas Medical Center Charlotte, NC percent of total billed charges · inpatientfrom % of charges | 1 | $1,690 | $48.14 – $3,403 |
| 23 | Carolinas Medical Center Charlotte, NC percent of total billed charges · outpatientfrom % of charges | 1 | $1,690 | $48.14 – $3,403 |
| 24 | Carolinas Medical Center Davidson, NC percent of total billed charges · inpatientfrom % of charges | 1 | $1,792 | $51.04 – $3,608 |
| 25 | Carolinas Medical Center Davidson, NC percent of total billed charges · outpatientfrom % of charges | 1 | $1,792 | $51.04 – $3,608 |
← Payers reporting HCPCS A2007 · Snapshot 20261109T115250Z-6452cf6e