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 Humana 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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447 hospital rates
| # | Plans | |||
|---|---|---|---|---|
| 1 | ALBANY GENERAL HOSPITAL Albany, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $1,951 | $105.30 – $17,355 |
| 2 | ALBANY GENERAL HOSPITAL Albany, OR professional · percent of total billed charges · outpatientfrom % of charges | 4 | $63.00 | $63.00 – $63.00 |
| 3 | AMH Cath Labs LLC Arlington, TX case rate · outpatient | 2 | $130.23 | $130.23 – $130.23 |
| 4 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH per diem · inpatient | 1 | $5,829 | $5,829 – $5,829 |
| 5 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 1 | $118.83 | $118.83 – $118.83 |
| 6 | Alton Memorial Hospital Alton, IL other · both | 1 | $133.36 | $133.36 – $133.36 |
| 7 | Alton Memorial Hospital Alton, IL percent of total billed charges · bothfrom % of charges | 1 | $0.01 | $0.01 – $0.01 |
| 8 | Amisub of South Carolina, Inc. Fort Mill, SC fee schedule · outpatient | 1 | $198.44 | $198.44 – $198.44 |
| 9 | Aspirus St. Luke’s Hospital Duluth, MN fee schedule · outpatient | 1 | $135.28 | $135.28 – $135.28 |
| 10 | Athens Hospital, LLC Athens, TX facility · percent of total billed charges · bothfrom % of charges | 1 | $889.17 | $203.52 – $1,824 |
| 11 | BAPTIST HOSPITAL OF MIAMI PLANTATION, FL fee schedule · both | 2 | $141.65 | $141.65 – $141.65 |
| 12 | BETHESDA HOSPITAL BOYNTON BEACH, FL fee schedule · both | 2 | $135.15 | $135.15 – $135.15 |
| 13 | BOCA RATON REGIONAL HOSPITAL Delray Beach, FL fee schedule · both | 1 | $132.73 | $132.73 – $132.73 |
| 14 | Barnes Jewish Hospital St. Louis, MO other · both | 1 | $124.65 | $124.65 – $124.65 |
| 15 | Barnes Jewish Hospital St. Louis, MO percent of total billed charges · bothfrom % of charges | 1 | $171.33 | $0.01 – $358.73 |
| 16 | Bartow Regional Medical Center Bartow, FL facility · case rate · outpatient | 1 | $332.16 | $332.16 – $332.16 |
| 17 | Baxter County Regional Hospital, Inc. Home, AR facility · fee schedule · outpatient | 1 | $126.80 | $126.80 – $126.80 |
| 18 | BayCare Alliant Hospital Dunedin, FL facility · case rate · outpatient | 1 | $332.16 | $332.16 – $332.16 |
| 19 | Baycare Hospital Wesley Chapel Chapel, FL facility · case rate · outpatient | 1 | $332.16 | $332.16 – $332.16 |
| 20 | Betsy Johnson Hospital Dunn, NC facility · other · outpatient | 1 | $126.52 | $126.52 – $126.52 |
| 21 | Boulder Community Health Lafayette, CO facility · case rate · outpatient | 1 | $135.39 | $135.39 – $135.39 |
| 22 | Boulder Community Health Lafayette, CO professional · fee schedule · both | 1 | $135.40 | $135.40 – $135.40 |
| 23 | Broaddus Hospital Association Inc Philippi, WV professional · fee schedule · both | 1 | $110.59 | $110.59 – $110.59 |
| 24 | Brookings Health System Brookings, SD percent of total billed charges · outpatientfrom % of charges | 1 | $2,694 | $1,320 – $4,557 |
| 25 | Brunswick Community Hospital, LLC Bolivia, NC fee schedule · outpatient | 1 | $133.48 | $133.48 – $133.48 |
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