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
$3.4k
Median
$185
High
$41.0k
Each hospital's average Cigna rate, under the methodology and billing class chosen below.
1111 hospitals; the 90th percentile is 191.3× 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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1,526 hospital rates
iThe hospitals that file a Cigna 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 | St Joseph Mercy Ann Arbor Ypsilanti, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $222 | $579 | $1.2k | 204% | 125 | $64 – $3.9k |
| 2 | Brigham and Women's Hospital Boston, MA percent of total billed charges · outpatientfrom % of charges | 1 | $4.1k | $5.0k | $4.5k | 90% | 26 | $33 – $16.4k |
| 3 | Massachusetts General Hospital Boston, MA percent of total billed charges · outpatientfrom % of charges | 1 | $3.6k | $4.5k | $3.8k | 85% | 26 | $33 – $13.1k |
| 4 | North Carolina Baptist Hospital Bermuda Run, NC percent of total billed charges · outpatientfrom % of charges | 3 | $1.7k | $2.2k | $1.9k | 85% | 18–180 | $275 – $8.6k |
| 5 | DIGNITY COMMUNITY CARE Chandler, AZ fee schedule · outpatient | 3 | $66 | $72 | $11 | 15% | 9–90 | $62 – $87 |
| 6 | University of Virginia Prince William Medical Center Manassas, VA fee schedule · both | 3 | $114 | $109 | $6 | 6% | 6–60 | $100 – $114 |
| 7 | North Carolina Baptist Hospital Winston Salem, NC percent of total billed charges · outpatientfrom % of charges | 3 | $671 | $799 | $380 | 48% | 2–20 | $412 – $1.3k |
| 8 | MedStar Georgetown Hospital Washington, DC facility · percent of total billed charges · outpatientfrom % of charges | 2 | $19.0k | $16.5k | $5.0k | 30% | 1–10 | $10.4k – $21.6k |
| 9 | Wheeling Hospital, Inc. Wheeling, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $6.6k | $6.6k | — | — | 1–10 | $6.6k – $6.6k |
| 10 | ACADIA GENERAL HOSPITAL, INC 1305 CROWLEY RAYNE HWY other · inpatient | 1 | $18.2k | $20.4k | $7.8k | 38% | — | $11.6k – $32.1k |
| 11 | ACADIA GENERAL HOSPITAL, INC 1305 CROWLEY RAYNE HWY other · outpatient | 1 | $19.5k | $21.9k | $8.3k | 38% | — | $12.5k – $34.4k |
| 12 | ADVENTIST HEALTH TULARE Tulare, CA percent of total billed charges · outpatientfrom % of charges | 1 | $5k | $5k | — | — | — | $5k – $5k |
| 13 | AGH LAVEEN LLC Phoenix, AZ fee schedule · outpatient | 2 | $94 | $94 | — | — | — | $94 – $94 |
| 14 | AGH MESA LLC Mesa, AZ fee schedule · outpatient | 2 | $94 | $94 | — | — | — | $94 – $94 |
| 15 | AHS Southcrest Hospital, LLC Tulsa, OK facility · percent of total billed charges · bothfrom % of charges | 1 | $5.4k | $5.8k | $2.4k | 41% | — | $3.1k – $8.8k |
| 16 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · fee schedule · outpatient | 1 | $121 | $121 | — | — | — | $121 – $121 |
| 17 | ALBANY GENERAL HOSPITAL Albany, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $392 | $13.1k | $18.2k | 138% | — | $188 – $38.8k |
| 18 | ALLE-KISKI MEDICAL CENTER NATRONA HEIGHTS, PA fee schedule · inpatient | 1 | $52 | $52 | — | — | — | $52 – $52 |
| 19 | ALLE-KISKI MEDICAL CENTER NATRONA HEIGHTS, PA fee schedule · outpatient | 1 | $52 | $52 | — | — | — | $52 – $52 |
| 20 | AMH Cath Labs LLC Arlington, TX percent of total billed charges · inpatientfrom % of charges | 1 | $404 | $403 | $212 | 53% | — | $162 – $643 |
| 21 | AMH Cath Labs LLC Arlington, TX percent of total billed charges · outpatientfrom % of charges | 3 | $284 | $313 | $182 | 58% | — | $95 – $643 |
| 22 | ANGEL MEDICAL CENTER Franklin, NC percent of total billed charges · outpatientfrom % of charges | 4 | $65 | $63 | $20 | 32% | — | $43 – $107 |
| 23 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH case rate · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 24 | Abbeville Area Medical Center Abbeville, SC facility · percent of total billed charges · outpatientfrom % of charges | 1 | $24.9k | $24.9k | $10.6k | 43% | — | $14.3k – $35.5k |
| 25 | Adena Fayette Medical Center Washington Court House, OH facility · percent of total billed charges · inpatientfrom % of charges | 1 | $11.3k | $11.3k | — | — | — | $11.3k – $11.3k |
← Payers reporting HCPCS Q4104 · Snapshot 20261111T120946Z-9134e7f7