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 UnitedHealthcare 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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1,158 hospital rates
| # | Plans | |||
|---|---|---|---|---|
| 1 | AHS Hillcrest Medical Center, LLC Tulsa, OK facility · percent of total billed charges · bothfrom % of charges | 2 | $5,066 | $2,610 – $9,242 |
| 2 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · fee schedule · outpatient | 1 | $173.16 | $173.16 – $173.16 |
| 3 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY facility · percent of total billed charges · bothfrom % of charges | 1 | $5,160 | $2,640 – $10,200 |
| 4 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY facility · percent of total billed charges · inpatientfrom % of charges | 1 | $4,838 | $2,475 – $9,563 |
| 5 | ALLE-KISKI MEDICAL CENTER NATRONA HEIGHTS, PA fee schedule · inpatient | 3 | $307.19 | $295.71 – $312.93 |
| 6 | ALLE-KISKI MEDICAL CENTER NATRONA HEIGHTS, PA fee schedule · outpatient | 3 | $307.19 | $295.71 – $312.93 |
| 7 | AMH Cath Labs LLC Arlington, TX case rate · outpatient | 2 | $140.25 | $138.99 – $141.50 |
| 8 | AMH Cath Labs LLC Arlington, TX percent of total billed charges · outpatientfrom % of charges | 3 | $129.02 | $13.17 – $366.23 |
| 9 | Acadia Hospital Bangor, ME professional · fee schedule · outpatient | 1 | $385.00 | $385.00 – $385.00 |
| 10 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 1 | $118.83 | $118.83 – $118.83 |
| 11 | Adventhealth Port Charlotte Port Charlotte, FL fee schedule · outpatient | 1 | $138.92 | $138.92 – $138.92 |
| 12 | Advocate Childrens Hospital Oak Lawn Oak Lawn, IL facility · fee schedule · outpatient | 2 | $208.47 | $136.77 – $280.17 |
| 13 | Advocate Childrens Hospital Park Ridge Park Ridge, IL facility · fee schedule · outpatient | 2 | $208.47 | $136.77 – $280.17 |
| 14 | Advocate Christ Medical Center Oak Lawn, IL facility · fee schedule · outpatient | 2 | $208.47 | $136.77 – $280.17 |
| 15 | Advocate Condell Medical Center Libertyville, IL fee schedule · outpatient | 2 | $198.94 | $178.21 – $219.66 |
| 16 | Advocate Good Samaritan Hospital Downers Grove, IL fee schedule · outpatient | 2 | $208.47 | $136.77 – $280.17 |
| 17 | Advocate Good Shepherd Hospital Barrington, IL fee schedule · outpatient | 2 | $208.47 | $136.77 – $280.17 |
| 18 | Advocate Illinois Masonic Medical Center Chicago, IL fee schedule · outpatient | 2 | $208.47 | $136.77 – $280.17 |
| 19 | Advocate Lutheran General Hospital Park Ridge, IL fee schedule · outpatient | 2 | $208.47 | $136.77 – $280.17 |
| 20 | Advocate Sherman Hospital Elgin, IL fee schedule · outpatient | 2 | $186.50 | $178.21 – $194.79 |
| 21 | Advocate South Suburban Hospital Hazel Crest, IL fee schedule · outpatient | 2 | $208.47 | $136.77 – $280.17 |
| 22 | Advocate Trinity Hospital Chicago, IL fee schedule · outpatient | 2 | $208.47 | $136.77 – $280.17 |
| 23 | Agnesian Healthcare Inc. Fond Du Lac, WI fee schedule · outpatient | 1 | $219.27 | $219.27 – $219.27 |
| 24 | Alleghany County Memorial Hospital, Inc Sparta, NC facility · percent of total billed charges · outpatientfrom % of charges | 3 | $1,047 | $19.72 – $3,178 |
| 25 | Allen Memorial Hospital Corporation Waterloo, IA fee schedule · both | 2 | $226.60 | $226.60 – $226.60 |
← Payers reporting HCPCS A2007 · Snapshot 20261109T115250Z-6452cf6e