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
OASIS BURN MATRIX, PER SQUARE CENTIMETER
Low
$12
Average
$344
Median
$217
High
$3.0k
Each hospital's average Ambetter rate, under the methodology and billing class chosen below.
120 hospitals; the 90th percentile is 15.9× 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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130 hospital rates
iThe hospitals that file a Ambetter 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 | BURLESON ST. JOSEPH HEALTH CENTER OF CALDWELL, TEXAS Caldwell, TX fee schedule · outpatient | 1 | $1.4k | $1.8k | $789 | 44% | — | $1.0k – $2.9k |
| 2 | Bartow Regional Medical Center Bartow, FL facility · percent of total billed charges · inpatientfrom % of charges | 2 | $440 | $440 | — | — | — | $440 – $440 |
| 3 | Bartow Regional Medical Center Bartow, FL facility · percent of total billed charges · outpatientfrom % of charges | 2 | $440 | $440 | — | — | — | $440 – $440 |
| 4 | Baycare Hospital Wesley Chapel Chapel, FL facility · percent of total billed charges · inpatientfrom % of charges | 2 | $440 | $440 | — | — | — | $440 – $440 |
| 5 | Baycare Hospital Wesley Chapel Chapel, FL facility · percent of total billed charges · outpatientfrom % of charges | 2 | $440 | $440 | — | — | — | $440 – $440 |
| 6 | Brunswick Community Hospital, LLC Bolivia, NC fee schedule · outpatient | 1 | $300 | $300 | — | — | — | $300 – $300 |
| 7 | CentraState Medical Center Freehold Township, NJ other · outpatient | 1 | $2.0k | $2.0k | — | — | — | $2.0k – $2.0k |
| 8 | Central Community Hospital Elkader, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $211 | $211 | — | — | — | $211 – $211 |
| 9 | Chilton Medical Center Pompton Plains, NJ other · outpatient | 1 | $2.0k | $2.0k | — | — | — | $2.0k – $2.0k |
| 10 | Good Samaritan Hospital Puyallup, WA fee schedule · outpatient | 1 | $285 | $285 | — | — | — | $285 – $285 |
| 11 | Grady Memorial Hospital Atlanta, GA facility · fee schedule · outpatient | 1 | $12 | $12 | — | — | — | $12 – $12 |
| 12 | Grady Memorial Hospital Atlanta, GA professional · fee schedule · outpatient | 1 | $12 | $12 | — | — | — | $12 – $12 |
| 13 | HH HEALTH SYSTEM DEKALB REGIONAL Payne, AL fee schedule · both | 1 | $226 | $226 | — | — | — | $226 – $226 |
| 14 | Hackettstown Medical Center Hackettstown, NJ other · outpatient | 1 | $2.0k | $2.0k | — | — | — | $2.0k – $2.0k |
| 15 | Hardin County General Hospital Savannah, TN facility · fee schedule · outpatient | 1 | $181 | $181 | — | — | — | $181 – $181 |
| 16 | Hendrick Medical Center Brownwood, TX facility · case rate · outpatient | 1 | $284 | $284 | — | — | — | $284 – $284 |
| 17 | HonorHealth Florence Medical Center Florence, AZ facility · fee schedule · outpatient | 1 | $189 | $189 | — | — | — | $189 – $189 |
| 18 | Honorhealth Deer Valley Medical Center Phoenix, AZ facility · fee schedule · outpatient | 1 | $189 | $189 | — | — | — | $189 – $189 |
| 19 | Honorhealth Four Peaks Medical Center Mesa, AZ facility · fee schedule · outpatient | 1 | $189 | $189 | — | — | — | $189 – $189 |
| 20 | Honorhealth John C. Lincoln Medical Center Phoenix, AZ facility · fee schedule · outpatient | 1 | $189 | $189 | — | — | — | $189 – $189 |
| 21 | Honorhealth Scottsdale Osborn Medical Center Scottsdale, AZ facility · fee schedule · outpatient | 1 | $189 | $189 | — | — | — | $189 – $189 |
| 22 | Honorhealth Scottsdale Shea Medical Center Scottsdale, AZ facility · fee schedule · outpatient | 1 | $189 | $189 | — | — | — | $189 – $189 |
| 23 | Honorhealth Scottsdale Thompson Peak Med Center Scottsdale, AZ facility · fee schedule · outpatient | 1 | $189 | $189 | — | — | — | $189 – $189 |
| 24 | Honorhealth Sonoran Crossing Medical Center Phoenix, AZ facility · fee schedule · outpatient | 1 | $189 | $189 | — | — | — | $189 – $189 |
| 25 | Indiana University Health Arnett Inc. Lafayette, IN fee schedule · outpatient | 1 | $218 | $218 | — | — | — | $218 – $218 |
← Payers reporting HCPCS Q4103 · Snapshot 20261111T120946Z-9134e7f7