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
WOUND MATRIX SYN 10X23CM (230 SQ CM) PELASHIELDAM
Low
$31
Average
$243
Median
$119
High
$1.8k
Each hospital's average WellCare rate, under the methodology and billing class chosen below.
42 hospitals; the 90th percentile is 6.1× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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46 hospital rates
iThe hospitals that file a WellCare 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.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | AMH Cath Labs LLC Arlington, TX case rate · outpatient | 2 | $130 | $130 | $3 | 2% | — | $127 – $133 |
| 2 | CLOVIS COMMUNITY MEDICAL CENTER Clovis, CA facility · case rate · inpatient | 1 | $139 | $139 | — | — | — | $139 – $139 |
| 3 | Canton-Potsdam Hospital Potsdam, NY facility · fee schedule · outpatient | 2 | $123 | $123 | — | — | — | $123 – $123 |
| 4 | Carle BroMenn Medical Center Normal, IL case rate · outpatient | 1 | $116 | $116 | — | — | — | $116 – $116 |
| 5 | Carle Eureka Hospital Eureka, IL case rate · outpatient | 1 | $116 | $116 | — | — | — | $116 – $116 |
| 6 | CentraState Medical Center Freehold Township, NJ other · outpatient | 2 | $710 | $710 | — | — | — | $710 – $710 |
| 7 | Chilton Medical Center Pompton Plains, NJ other · outpatient | 2 | $710 | $710 | — | — | — | $710 – $710 |
| 8 | FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER Fresno, CA facility · fee schedule · inpatient | 1 | $139 | $139 | — | — | — | $139 – $139 |
| 9 | Hackettstown Medical Center Hackettstown, NJ other · outpatient | 2 | $710 | $710 | — | — | — | $710 – $710 |
| 10 | Inspira Medical Center Mullica Hill Hill, NJ fee schedule · outpatient | 1 | $139 | $139 | — | — | — | $139 – $139 |
| 11 | Inspira Medical Center Vineland Vineland, NJ fee schedule · outpatient | 1 | $139 | $139 | — | — | — | $139 – $139 |
| 12 | Kirby Medical Center Monticello, IL professional · fee schedule · both | 1 | $116 | $116 | — | — | — | $116 – $116 |
| 13 | Methodist Medical Center of Illinois Peoria, IL case rate · outpatient | 1 | $116 | $116 | — | — | — | $116 – $116 |
| 14 | Morristown Medical Center Morristown, NJ other · outpatient | 2 | $710 | $710 | — | — | — | $710 – $710 |
| 15 | Munson Healthcare Cadillac Cadillac, MI facility · fee schedule · outpatient | 1 | $116 | $116 | — | — | — | $116 – $116 |
| 16 | Munson Healthcare Cadillac Cadillac, MI professional · fee schedule · both | 1 | $116 | $116 | — | — | — | $116 – $116 |
| 17 | Munson Healthcare Grayling Grayling, MI facility · fee schedule · outpatient | 1 | $116 | $116 | — | — | — | $116 – $116 |
| 18 | Munson Healthcare Grayling Grayling, MI professional · fee schedule · both | 1 | $116 | $116 | — | — | — | $116 – $116 |
| 19 | Munson Healthcare Manistee Hospital Manistee, MI facility · fee schedule · outpatient | 1 | $116 | $116 | — | — | — | $116 – $116 |
| 20 | Munson Healthcare Manistee Hospital Manistee, MI professional · fee schedule · both | 1 | $116 | $116 | — | — | — | $116 – $116 |
| 21 | Newton Medical Center Newton, NJ other · outpatient | 2 | $710 | $710 | — | — | — | $710 – $710 |
| 22 | Overlook Medical Center Summit, NJ other · outpatient | 2 | $710 | $710 | — | — | — | $710 – $710 |
| 23 | Pekin Memorial Hospital Pekin, IL case rate · outpatient | 1 | $116 | $116 | — | — | — | $116 – $116 |
| 24 | Proctor Community Hospital Peoria, IL case rate · outpatient | 1 | $116 | $116 | — | — | — | $116 – $116 |
| 25 | Samaritan Medical Center Watertown, NY facility · case rate · outpatient | 1 | $121 | $121 | — | — | — | $121 – $121 |
← Payers reporting HCPCS A4100 · Snapshot 20261111T120946Z-9134e7f7