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
$35
Average
$822
Median
$182
High
$11.8k
Each hospital's average Highmark rate, under the methodology and billing class chosen below.
114 hospitals; the 90th percentile is 40.3× 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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138 hospital rates
iThe hospitals that file a Highmark 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 | ALLE-KISKI MEDICAL CENTER NATRONA HEIGHTS, PA fee schedule · inpatient | 11 | $62 | $62 | $1 | 2% | — | $58 – $62 |
| 2 | ALLE-KISKI MEDICAL CENTER NATRONA HEIGHTS, PA fee schedule · outpatient | 11 | $62 | $62 | $1 | 2% | — | $58 – $62 |
| 3 | Broaddus Hospital Association Inc Philippi, WV professional · fee schedule · both | 2 | $86 | $86 | $25 | 29% | — | $61 – $111 |
| 4 | Bryn Mawr Rehabilitation Hospital Malvern, PA facility · fee schedule · outpatient | 1 | $92 | $92 | $42 | 46% | — | $50 – $135 |
| 5 | CANONSBURG GENERAL HOSPITAL CANONSBURG, PA fee schedule · inpatient | 11 | $62 | $62 | $1 | 2% | — | $58 – $62 |
| 6 | CANONSBURG GENERAL HOSPITAL CANONSBURG, PA fee schedule · outpatient | 11 | $62 | $62 | $1 | 2% | — | $58 – $62 |
| 7 | Camden-Clark Memorial Hospital Corporation Parkersburg, WV facility · other · outpatient | 1 | $132 | $132 | — | — | — | $132 – $132 |
| 8 | Champlain Valley Physicians Hospital Medical Center Plattsburgh, NY facility · fee schedule · outpatient | 2 | $94 | $94 | — | — | — | $94 – $94 |
| 9 | City Hospital, Inc. Martinsburg, WV facility · other · outpatient | 2 | $131 | $131 | $1 | 0% | — | $130 – $132 |
| 10 | Clifton Springs Hospital And Clinic Clifton Springs, NY facility · fee schedule · outpatient | 1 | $35 | $35 | — | — | — | $35 – $35 |
| 11 | Davis Medical Center Elkins, WV facility · case rate · outpatient | 1 | $118 | $118 | — | — | — | $118 – $118 |
| 12 | Davis Medical Center Elkins, WV professional · fee schedule · both | 2 | $88 | $88 | $28 | 31% | — | $61 – $116 |
| 13 | Diley Ridge Medical Center Canal Winchester, OH facility · percent of total billed charges · bothfrom % of charges | 1 | $154 | $805 | $1.7k | 217% | — | $65 – $5.4k |
| 14 | Doylestown Hospital Doylestown, PA facility · fee schedule · outpatient | 1 | $261 | $2.0k | $3.0k | 150% | — | $261 – $7.1k |
| 15 | ERIE COUNTY MEDICAL CENTER CORPORATION Buffalo, NY fee schedule · both | 7 | $77 | $949 | $1.2k | 123% | — | $69 – $3.4k |
| 16 | F.F. Thompson Hospital Canandaigua, NY fee schedule · outpatient | 1 | $127 | $127 | — | — | — | $127 – $127 |
| 17 | Fox Chase Cancer Center Philadelphia, PA facility · fee schedule · outpatient | 2 | $56 | $56 | $5 | 9% | — | $51 – $61 |
| 18 | GROVE CITY MEDICAL CENTER GROVE CITY, PA fee schedule · inpatient | 11 | $62 | $62 | $1 | 2% | — | $58 – $62 |
| 19 | GROVE CITY MEDICAL CENTER GROVE CITY, PA fee schedule · outpatient | 11 | $62 | $62 | $1 | 2% | — | $58 – $62 |
| 20 | Geisinger St Luke's Hospital - Orwigsburg Campus Orwigsburg, PA facility · fee schedule · outpatient | 1 | $117 | $117 | — | — | — | $117 – $117 |
| 21 | Herbert J Thomas Memorial Hospital Association South Charleston, WV facility · other · outpatient | 1 | $132 | $132 | — | — | — | $132 – $132 |
| 22 | Highland Hospital Rochester, NY fee schedule · outpatient | 1 | $155 | $155 | — | — | — | $155 – $155 |
| 23 | Holy Cross Germantown Hospital Germantown, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $207 | $1.1k | $2.9k | 250% | — | $70 – $9.7k |
| 24 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · per diem · both | 1 | $763 | $763 | — | — | — | $763 – $763 |
| 25 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $164 | $1.1k | $2.8k | 259% | — | $51 – $9.5k |
← Payers reporting HCPCS Q4104 · Snapshot 20261111T120946Z-9134e7f7