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
MATRIX TISSUE 20X16CM ALLODERM SELECT THK.4-2.4MM THICK
Low
$0
Average
$2.9k
Median
$1.6k
High
$14.8k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
67 payers; the 90th percentile is 52.2× the 10th. Each bar is a price range and its height is how many payers fall in it. Hover a bar, or a row in the ladder, for details.
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| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Blue Cross Blue Shield fee schedule · outpatient · +29 other terms | 254 | $130 | $1.2k | $4.2k | 351% | 160–1,312 | $0 – $73.7k |
| 2 | Cigna fee schedule · outpatient · +24 other terms | 295 | $87 | $3.2k | $9.9k | 309% | 80–800 | $0 – $96.3k |
| 3 | Anthem fee schedule · outpatient · +21 other terms | 89 | $125 | $3.9k | $11.4k | 288% | 18–180 | $2 – $99.4k |
| 4 | Molina fee schedule · outpatient · +21 other terms | 69 | $191 | $1.4k | $4.2k | 301% | 18–180 | $1 – $53.5k |
| 5 | UnitedHealthcare fee schedule · outpatient · +26 other terms | 386 | $210 | $5.2k | $9.5k | 184% | 7–70 | $1 – $103.6k |
| 6 | Aetna fee schedule · outpatient · +26 other terms | 245 | $127 | $6.8k | $11.5k | 168% | — | $0 – $87.7k |
| 7 | Humana fee schedule · outpatient · +23 other terms | 193 | $127 | $7.1k | $13.7k | 192% | — | $1 – $81.8k |
| 8 | MultiPlan fee schedule · outpatient · +18 other terms | 75 | $16.1k | $14.9k | $19.7k | 132% | — | $1 – $136.5k |
| 9 | Kaiser fee schedule · outpatient · +19 other terms | 63 | $380 | $4.2k | $9.4k | 224% | — | $1 – $76.5k |
| 10 | Ambetter facility · fee schedule · outpatient · +13 other terms | 61 | $212 | $271 | $381 | 140% | — | $129 – $7.6k |
| 11 | WellCare facility · fee schedule · outpatient · +16 other terms | 52 | $127 | $203 | $824 | 406% | — | $110 – $13.3k |
| 12 | Devoted facility · fee schedule · outpatient · +13 other terms | 44 | $118 | $121 | $6 | 5% | — | $111 – $162 |
| 13 | Medcost percent of total billed charges · bothfrom % of charges · +5 other terms | 42 | $9.9k | $1.6k | $9.2k | 557% | — | $60 – $174.8k |
| 14 | Tricare facility · fee schedule · outpatient · +13 other terms | 39 | $127 | $885 | $3.6k | 402% | — | $109 – $36.8k |
| 15 | Optum fee schedule · outpatient · +17 other terms | 36 | $187 | $12.7k | $17.6k | 139% | — | $1 – $96.6k |
| 16 | First Health fee schedule · outpatient · +15 other terms | 34 | $15.5k | $17.1k | $19.5k | 114% | — | $30 – $87.7k |
| 17 | Oscar facility · fee schedule · outpatient · +10 other terms | 31 | $185 | $230 | $631 | 274% | — | $143 – $6.3k |
| 18 | Bcbs Tx fee schedule · outpatient · +3 other terms | 30 | $153 | $139 | $46 | 33% | — | $57 – $240 |
| 19 | Caresource fee schedule · outpatient · +13 other terms | 30 | $202 | $302 | $613 | 203% | — | $1 – $7.1k |
| 20 | Medica fee schedule · outpatient · +16 other terms | 29 | $1.6k | $4.0k | $6.4k | 162% | — | $38 – $41.7k |
| 21 | Medicare fee schedule · outpatient · +13 other terms | 27 | $125 | $114 | $42 | 37% | — | $1 – $246 |
| 22 | Amerihealth Caritas other · outpatient · +9 other terms | 25 | $3.6k | $4.1k | $7.0k | 170% | — | $14 – $77.2k |
| 23 | Baylor Scott White Health Plan facility · fee schedule · outpatient · +2 other terms | 25 | $158 | $158 | $31 | 20% | — | $119 – $207 |
| 24 | Phcs fee schedule · inpatient · +11 other terms | 25 | $20.2k | $15.3k | $19.9k | 130% | — | $30 – $112.9k |
| 25 | Bcbs La fee schedule · outpatient · +2 other terms | 24 | $34 | $34 | — | — | — | $34 – $34 |
← Hospitals reporting HCPCS Q4116 · Snapshot 20261111T120946Z-9134e7f7