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 Oscar 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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69 hospital rates
| # | Plans | |||
|---|---|---|---|---|
| 1 | AHS Hillcrest Medical Center, LLC Tulsa, OK facility · percent of total billed charges · bothfrom % of charges | 2 | $5,329 | $1,478 – $13,757 |
| 2 | Adventhealth Port Charlotte Port Charlotte, FL fee schedule · outpatient | 1 | $237.30 | $237.30 – $237.30 |
| 3 | Banner Desert Medical Center Mesa, AZ facility · percent of total billed charges · outpatientfrom % of charges | 1 | $62.63 | $55.95 – $69.30 |
| 4 | Bethesda Hospital Inc. Lebanon, OH facility · fee schedule · outpatient | 1 | $181.91 | $181.91 – $181.91 |
| 5 | CentraState Medical Center Freehold Township, NJ percent of total billed charges · bothfrom % of charges | 1 | $17,729 | $4,933 – $49,381 |
| 6 | Chilton Medical Center Pompton Plains, NJ percent of total billed charges · bothfrom % of charges | 1 | $2,478 | $2,478 – $2,478 |
| 7 | Floyd Healthcare Management Inc Rome, GA percent of total billed charges · inpatientfrom % of charges | 1 | $712.64 | $20.30 – $1,435 |
| 8 | Floyd Healthcare Management Inc Rome, GA percent of total billed charges · outpatientfrom % of charges | 1 | $397.04 | $11.31 – $799.50 |
| 9 | High Point Regional Health High Point, NC percent of total billed charges · inpatientfrom % of charges | 1 | $814.44 | $23.20 – $1,640 |
| 10 | High Point Regional Health High Point, NC percent of total billed charges · outpatientfrom % of charges | 1 | $610.83 | $17.40 – $1,230 |
| 11 | HonorHealth Florence Medical Center Florence, AZ facility · fee schedule · outpatient | 1 | $175.29 | $175.29 – $175.29 |
| 12 | Honorhealth Deer Valley Medical Center Phoenix, AZ facility · fee schedule · outpatient | 1 | $175.29 | $175.29 – $175.29 |
| 13 | Honorhealth Four Peaks Medical Center Mesa, AZ facility · fee schedule · outpatient | 1 | $175.29 | $175.29 – $175.29 |
| 14 | Honorhealth John C. Lincoln Medical Center Phoenix, AZ facility · fee schedule · outpatient | 1 | $175.29 | $175.29 – $175.29 |
| 15 | Honorhealth Scottsdale Osborn Medical Center Scottsdale, AZ facility · fee schedule · outpatient | 1 | $175.29 | $175.29 – $175.29 |
| 16 | Honorhealth Scottsdale Shea Medical Center Scottsdale, AZ facility · fee schedule · outpatient | 1 | $175.29 | $175.29 – $175.29 |
| 17 | Honorhealth Scottsdale Thompson Peak Med Center Scottsdale, AZ facility · fee schedule · outpatient | 1 | $175.29 | $175.29 – $175.29 |
| 18 | Honorhealth Sonoran Crossing Medical Center Phoenix, AZ facility · fee schedule · outpatient | 1 | $175.29 | $175.29 – $175.29 |
| 19 | Ingalls Memorial Hospital Harvey, IL fee schedule · outpatient | 1 | $146.69 | $146.69 – $146.69 |
| 20 | Lakewood Medical Center Kansas City, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $7,097 | $3,217 – $12,649 |
| 21 | Lexington Medical Center Lexington, NC percent of total billed charges · inpatientfrom % of charges | 1 | $895.88 | $25.52 – $1,804 |
| 22 | Lexington Medical Center Lexington, NC percent of total billed charges · outpatientfrom % of charges | 1 | $651.55 | $18.56 – $1,312 |
| 23 | McCullough-Hyde Memorial Hospital, Inc. Oxford, OH facility · fee schedule · outpatient | 1 | $181.91 | $181.91 – $181.91 |
| 24 | Mercy Health Lakeshore Campus Shelby, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $89.37 | $54.57 – $125.07 |
| 25 | Mercy Medical Center - New Hampton New Hampton, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $199.57 | $121.86 – $279.29 |
← Payers reporting HCPCS A2007 · Snapshot 20261109T115250Z-6452cf6e