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
DRSG WND MESH BOVINE BILAYER 4X10IN MATRIX-Q4104-COST PER SQ CM
Low
$0
Average
$3.8k
Median
$200
High
$46.3k
Each hospital's average Aetna rate, under the methodology and billing class chosen below.
1250 hospitals; the 90th percentile is 182.9× 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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1,803 hospital rates
iThe hospitals that file a Aetna 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 | Massachusetts General Hospital Boston, MA percent of total billed charges · outpatientfrom % of charges | 1 | $3.6k | $4.5k | $3.8k | 85% | 11–110 | $33 – $13.1k |
| 2 | Virtua_West_Jersey_Health_System_Inc Marlton, NJ percent of total billed charges · outpatientfrom % of charges | 1 | $5.6k | $5.6k | — | — | 8–80 | $5.6k – $5.6k |
| 3 | Virtua_West_Jersey_Health_System_Inc Voorhees, NJ percent of total billed charges · outpatientfrom % of charges | 1 | $5.6k | $5.6k | — | — | 8–80 | $5.6k – $5.6k |
| 4 | NYU Langone Mineola, NY percent of total billed charges · bothfrom % of charges | 25 | $17.6k | $17.6k | — | — | 1–10 | $17.6k – $17.6k |
| 5 | NYU Langone Brooklyn, NY percent of total billed charges · bothfrom % of charges | 25 | $22.3k | $22.3k | — | — | 1–10 | $22.3k – $22.3k |
| 6 | NYU Langone Hospital?Suffolk Patchogue, NY percent of total billed charges · bothfrom % of charges | 25 | $15.0k | $15.0k | — | — | 1–10 | $15.0k – $15.0k |
| 7 | ACADIA GENERAL HOSPITAL, INC 1305 CROWLEY RAYNE HWY other · inpatient | 1 | $18.2k | $20.4k | $7.8k | 38% | — | $11.6k – $32.1k |
| 8 | ACADIA GENERAL HOSPITAL, INC 1305 CROWLEY RAYNE HWY other · outpatient | 1 | $18.2k | $20.4k | $7.8k | 38% | — | $11.6k – $32.1k |
| 9 | ADVENTIST HEALTH TULARE Tulare, CA percent of total billed charges · outpatientfrom % of charges | 1 | $22.2k | $22.2k | $4.3k | 19% | — | $18.0k – $26.5k |
| 10 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · fee schedule · outpatient | 3 | $118 | $109 | $13 | 12% | — | $91 – $119 |
| 11 | ALBANY GENERAL HOSPITAL Albany, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $392 | $13.1k | $18.2k | 138% | — | $188 – $38.8k |
| 12 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY facility · percent of total billed charges · outpatientfrom % of charges | 2 | $2.4k | $3.2k | $2.3k | 73% | — | $752 – $8.6k |
| 13 | AMH Cath Labs LLC Arlington, TX percent of total billed charges · inpatientfrom % of charges | 2 | $162 | $173 | $95 | 55% | — | $60 – $315 |
| 14 | AMH Cath Labs LLC Arlington, TX percent of total billed charges · outpatientfrom % of charges | 5 | $149 | $211 | $155 | 74% | — | $17 – $479 |
| 15 | ANGEL MEDICAL CENTER Franklin, NC percent of total billed charges · outpatientfrom % of charges | 2 | $60 | $66 | $35 | 53% | — | $27 – $117 |
| 16 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH per diem · inpatient | 1 | $5.4k | $5.4k | — | — | — | $5.4k – $5.4k |
| 17 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH percent of total billed charges · inpatientfrom % of charges | 3 | $64 | $1.2k | $4.4k | 360% | — | $17 – $23.5k |
| 18 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH percent of total billed charges · outpatientfrom % of charges | 6 | $60 | $1.2k | $4.4k | 374% | — | $14 – $23.5k |
| 19 | Abbeville Area Medical Center Abbeville, SC facility · percent of total billed charges · outpatientfrom % of charges | 2 | $14.9k | $18.0k | $11.0k | 61% | — | $6.2k – $36.0k |
| 20 | Acadia Hospital Bangor, ME professional · fee schedule · outpatient | 2 | $70 | $70 | $19 | 27% | — | $51 – $89 |
| 21 | Adena Fayette Medical Center Washington Court House, OH facility · fee schedule · outpatient | 1 | $123 | $123 | — | — | — | $123 – $123 |
| 22 | Adena Fayette Medical Center Washington Court House, OH facility · percent of total billed charges · inpatientfrom % of charges | 1 | $13.0k | $13.0k | — | — | — | $13.0k – $13.0k |
| 23 | Adena Fayette Medical Center Washington Court House, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $6.7k | $6.7k | — | — | — | $6.7k – $6.7k |
| 24 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 2 | $122 | $122 | $3 | 2% | — | $119 – $125 |
| 25 | Adena Health System Chillicothe, OH facility · percent of total billed charges · inpatientfrom % of charges | 1 | $11.7k | $11.7k | — | — | — | $11.7k – $11.7k |
← Payers reporting HCPCS Q4104 · Snapshot 20261111T120946Z-9134e7f7