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 Highmark 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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82 hospital rates
| # | Plans | |||
|---|---|---|---|---|
| 1 | ALLE-KISKI MEDICAL CENTER NATRONA HEIGHTS, PA fee schedule · inpatient | 11 | $226.27 | $226.27 – $226.27 |
| 2 | ALLE-KISKI MEDICAL CENTER NATRONA HEIGHTS, PA fee schedule · outpatient | 11 | $226.27 | $226.27 – $226.27 |
| 3 | Broaddus Hospital Association Inc Philippi, WV professional · fee schedule · both | 2 | $163.29 | $110.59 – $215.99 |
| 4 | Bryn Mawr Rehabilitation Hospital Malvern, PA facility · fee schedule · outpatient | 1 | $134.55 | $134.55 – $134.55 |
| 5 | CANONSBURG GENERAL HOSPITAL CANONSBURG, PA fee schedule · inpatient | 11 | $226.27 | $226.27 – $226.27 |
| 6 | CANONSBURG GENERAL HOSPITAL CANONSBURG, PA fee schedule · outpatient | 11 | $226.27 | $226.27 – $226.27 |
| 7 | CentraState Medical Center Freehold Township, NJ other · outpatient | 2 | $2,122 | $2,122 – $2,122 |
| 8 | Charleston Area Medical Center Charleston, WV percent of total billed charges · bothfrom % of charges | 4 | $8,262 | $2,250 – $12,886 |
| 9 | Chilton Medical Center Pompton Plains, NJ other · outpatient | 2 | $2,122 | $2,122 – $2,122 |
| 10 | Davis Medical Center Elkins, WV facility · case rate · outpatient | 1 | $118.18 | $118.18 – $118.18 |
| 11 | Davis Medical Center Elkins, WV professional · fee schedule · both | 2 | $166.06 | $116.12 – $215.99 |
| 12 | Diley Ridge Medical Center Canal Winchester, OH facility · percent of total billed charges · bothfrom % of charges | 1 | $202.29 | $123.52 – $283.09 |
| 13 | ERIE COUNTY MEDICAL CENTER CORPORATION Buffalo, NY fee schedule · both | 7 | $1,032 | $205.70 – $3,362 |
| 14 | F.F. Thompson Hospital Canandaigua, NY fee schedule · outpatient | 1 | $127.14 | $127.14 – $127.14 |
| 15 | GROVE CITY MEDICAL CENTER GROVE CITY, PA fee schedule · inpatient | 11 | $226.27 | $226.27 – $226.27 |
| 16 | GROVE CITY MEDICAL CENTER GROVE CITY, PA fee schedule · outpatient | 11 | $226.27 | $226.27 – $226.27 |
| 17 | HERITAGE VALLEY BEAVER BEAVER, PA fee schedule · both | 9 | $76.47 | $0.01 – $129.36 |
| 18 | HERITAGE VALLEY SEWICKLEY SEWICKLEY, PA fee schedule · both | 9 | $76.47 | $0.01 – $129.36 |
| 19 | Hackettstown Medical Center Hackettstown, NJ other · outpatient | 2 | $2,122 | $2,122 – $2,122 |
| 20 | Highland Hospital Rochester, NY fee schedule · outpatient | 1 | $155.34 | $155.34 – $155.34 |
| 21 | Holy Cross Germantown Hospital Germantown, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $287.14 | $188.58 – $367.07 |
| 22 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · per diem · both | 1 | $763.00 | $763.00 – $763.00 |
| 23 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $222.63 | $138.10 – $305.89 |
| 24 | Holy Redeemer Health System Meadowbrook, PA facility · case rate · outpatient | 1 | $132.89 | $132.89 – $132.89 |
| 25 | JEFFERSON REGIONAL MEDICAL CENTER JEFFERSON HILLS, PA fee schedule · inpatient | 11 | $226.27 | $226.27 – $226.27 |
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