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 Healthcare Highways 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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20 hospital rates
| # | Plans | |||
|---|---|---|---|---|
| 1 | AHS Hillcrest Medical Center, LLC Tulsa, OK facility · percent of total billed charges · bothfrom % of charges | 5 | $5,975 | $1,478 – $13,616 |
| 2 | Athens Hospital, LLC Athens, TX facility · percent of total billed charges · bothfrom % of charges | 3 | $347.33 | $79.50 – $712.50 |
| 3 | BSA Hospital Amarillo, TX facility · percent of total billed charges · bothfrom % of charges | 3 | $7,405 | $7,405 – $7,405 |
| 4 | Henderson Hospital, LLC Henderson, TX facility · percent of total billed charges · bothfrom % of charges | 3 | $712.50 | $712.50 – $712.50 |
| 5 | Jacksonville Hospital, LLC Jacksonville, TX facility · percent of total billed charges · bothfrom % of charges | 3 | $712.50 | $712.50 – $712.50 |
| 6 | MEDICAL CITY ARLINGTON GRAND PRAIRIE, TX percent of total billed charges · outpatientfrom % of charges | 1 | $432.30 | $432.30 – $432.30 |
| 7 | MEDICAL CITY DALLAS GARLAND, TX percent of total billed charges · outpatientfrom % of charges | 1 | $305.05 | $219.70 – $401.21 |
| 8 | MEDICAL CITY DECATUR DECATUR, TX percent of total billed charges · outpatientfrom % of charges | 1 | $903.14 | $903.14 – $903.14 |
| 9 | MEDICAL CITY DENTON Denton, TX percent of total billed charges · outpatientfrom % of charges | 1 | $1,147 | $336.65 – $4,211 |
| 10 | MEDICAL CITY FORT WORTH FORT WORTH, TX percent of total billed charges · outpatientfrom % of charges | 1 | $788.33 | $516.80 – $984.59 |
| 11 | MEDICAL CITY LEWISVILLE Lewisville, TX percent of total billed charges · outpatientfrom % of charges | 1 | $871.70 | $871.70 – $871.70 |
| 12 | MEDICAL CITY MCKINNEY MCKINNEY, TX percent of total billed charges · outpatientfrom % of charges | 1 | $407.63 | $407.63 – $407.63 |
| 13 | MEDICAL CITY PLANO Plano, TX percent of total billed charges · outpatientfrom % of charges | 1 | $549.78 | $272.43 – $889.95 |
| 14 | Medical City Argyle Argyle, TX percent of total billed charges · outpatientfrom % of charges | 1 | $1,147 | $336.65 – $4,211 |
| 15 | Mercy Hospital Oklahoma City Inc City, OK facility · percent of total billed charges · outpatientfrom % of charges | 2 | $199.24 | $123.24 – $293.40 |
| 16 | Pittsburg Hospital, LLC Pittsburg, TX facility · percent of total billed charges · bothfrom % of charges | 3 | $1,559 | $209.50 – $3,075 |
| 17 | Quitman Hospital, LLC Quitman, TX facility · percent of total billed charges · bothfrom % of charges | 3 | $825.05 | $24.75 – $3,075 |
| 18 | Rehabilitation Hospital, LLC Tyler, TX facility · percent of total billed charges · bothfrom % of charges | 3 | $250.00 | $250.00 – $250.00 |
| 19 | Tyler Regional Hospital, LLC Tyler, TX facility · percent of total billed charges · bothfrom % of charges | 3 | $1,615 | $26.25 – $4,734 |
| 20 | UNIVERSITY OF TEXAS HEALTH CENTER AT TYLER Tyler, TX facility · percent of total billed charges · bothfrom % of charges | 3 | $250.00 | $250.00 – $250.00 |
← Payers reporting HCPCS A2007 · Snapshot 20261109T115250Z-6452cf6e