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
$8
Average
$3.8k
Median
$249
High
$50.4k
Each hospital's average Aetna rate, under the methodology and billing class chosen below.
1329 hospitals; the 90th percentile is 174.3× 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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2,031 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 | Piedmont Atlanta Atlanta, GA percent of total billed charges · bothfrom % of charges | 2 | $16.9k | $21.9k | $12.0k | 55% | 11,639 | $3.5k – $44.5k |
| 2 | Brigham and Women's Faulkner Hospital Boston, MA percent of total billed charges · bothfrom % of charges | 1 | $3.2k | $3.1k | $2.2k | 71% | 3,696 | $34 – $8.1k |
| 3 | Massachusetts General Hospital Boston, MA percent of total billed charges · outpatientfrom % of charges | 2 | $4.4k | $5.5k | $4.1k | 75% | 3,055 | $50 – $18.4k |
| 4 | Piedmont Henry Stockbridge, GA percent of total billed charges · bothfrom % of charges | 2 | $16.9k | $21.9k | $12.0k | 55% | 2,617 | $3.5k – $44.5k |
| 5 | Newton Wellesley Hospital Newton, MA percent of total billed charges · bothfrom % of charges | 1 | $3.4k | $4.0k | $3.0k | 76% | 1,932 | $34 – $13.0k |
| 6 | GULF COAST MEDICAL CENTER FORT MYERS, FL facility · percent of total billed charges · bothfrom % of charges | 1 | $129 | $9.1k | $12.8k | 141% | 1,850 | $40 – $40.7k |
| 7 | St Luke's Regional Medical Center, LTD Mountain Home, ID percent of total billed charges · bothfrom % of charges | 2 | $56 | $84 | $57 | 68% | 641 | $38 – $203 |
| 8 | HEALTHPARK MEDICAL CENTER FORT MYERS, FL facility · percent of total billed charges · bothfrom % of charges | 1 | $129 | $9.1k | $12.8k | 141% | 640 | $40 – $40.7k |
| 9 | Piedmont Fayette Fayetteville, GA percent of total billed charges · bothfrom % of charges | 2 | $16.9k | $21.9k | $12.0k | 55% | 520 | $3.5k – $44.5k |
| 10 | Piedmont Athens Regional Athens, GA percent of total billed charges · bothfrom % of charges | 2 | $17.0k | $22.2k | $12.1k | 54% | 464 | $3.5k – $44.5k |
| 11 | Barnes Jewish Hospital St. Louis, MO percent of total billed charges · bothfrom % of charges | 4 | $76 | $82 | $37 | 45% | 460 | $1 – $197 |
| 12 | Brigham and Women's Hospital Boston, MA percent of total billed charges · outpatientfrom % of charges | 1 | $4.8k | $5.5k | $4.0k | 73% | 397 | $50 – $16.5k |
| 13 | Salem Hospital Salem, MA percent of total billed charges · bothfrom % of charges | 1 | $4.0k | $3.9k | $2.8k | 73% | 264 | $34 – $11.0k |
| 14 | Stony Brook University Hospital Stony Brook, NY facility · percent of total billed charges · outpatientfrom % of charges | 1 | $7.1k | $7.1k | — | — | 264 | $7.1k – $7.1k |
| 15 | University of Wisconsin Hospital and Clinics Authority WI 53718; 1675 Highland Ave Madison, WI percent of total billed chargesfrom % of charges | 2 | $2.7k | $5.0k | $4.0k | 80% | 128 | $1.4k – $13.2k |
| 16 | North Carolina Baptist Hospital Bermuda Run, NC percent of total billed charges · outpatientfrom % of charges | 3 | $903 | $1.6k | $1.9k | 117% | 124–1,240 | $17 – $8.7k |
| 17 | The University of Texas Southwestern Medical Center at Dallas Dallas, TX percent of total billed charges · outpatientfrom % of charges | 2 | $6.1k | $6.9k | $5.2k | 75% | 78–780 | $263 – $32.7k |
| 18 | Tucson Medical Center Tucson, AZ facility · percent of total billed charges · outpatientfrom % of charges | 1 | $3.0k | $4.2k | $3.8k | 91% | 65–650 | $127 – $15.0k |
| 19 | Tucson Medical Center Tucson, AZ facility · percent of total billed charges · outpatientfrom % of charges | 1 | $3.0k | $4.2k | $3.8k | 91% | 65–650 | $127 – $15.0k |
| 20 | Mayo Clinic Arizona Phoenix, AZ facility · percent of total billed charges · bothfrom % of charges | 3 | $6.0k | $6.2k | $4.7k | 75% | 45 | $623 – $17.3k |
| 21 | St Joseph Mercy Ann Arbor Ypsilanti, MI facility · percent of total billed charges · bothfrom % of charges | 4 | $38 | $91 | $302 | 333% | 36–360 | $2 – $2.3k |
| 22 | Sanford USD Medical Center Sioux Falls, SD percent of total billed charges · outpatientfrom % of charges | 1 | $113 | $155 | $110 | 71% | 35–350 | $67 – $471 |
| 23 | St. Lukes Hospital of Kansas City City, KS percent of total billed charges · bothfrom % of charges | 5 | $82 | $5.0k | $9.7k | 196% | 23–230 | $31 – $24.4k |
| 24 | Carolinas Medical Center Charlotte, NC percent of total billed charges · outpatientfrom % of charges | 5 | $195 | $203 | $122 | 60% | 20–200 | $39 – $532 |
| 25 | Mayo Clinic Florida Jacksonville, FL facility · percent of total billed charges · bothfrom % of charges | 3 | $5.6k | $9.0k | $8.5k | 94% | 20–200 | $518 – $34.2k |
← Payers reporting HCPCS Q4116 · Snapshot 20261111T120946Z-9134e7f7