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
$3.1k
Median
$311
High
$96.1k
Each hospital's average Blue Cross Blue Shield rate, under the methodology and billing class chosen below.
857 hospitals; the 90th percentile is 154.9× 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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1,277 hospital rates
iThe hospitals that file a Blue Cross Blue Shield 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 | Saint Luke’s South Hospital, Inc Leawood, KS percent of total billed charges · bothfrom % of charges | 18 | $42 | $61 | $81 | 132% | 1,842 | $9 – $706 |
| 2 | Saint Luke’s South Hospital, Inc Leawood, KS percent of total billed charges · outpatientfrom % of charges | 1 | $61 | $61 | — | — | 1,842 | $61 – $61 |
| 3 | Stony Brook University Hospital Stony Brook, NY facility · percent of total billed charges · outpatientfrom % of charges | 1 | $3.2k | $3.2k | — | — | 924 | $3.2k – $3.2k |
| 4 | St. Lukes Hospital of Kansas City City, KS percent of total billed charges · bothfrom % of charges | 18 | $43 | $67 | $93 | 138% | 824–1,031 | $17 – $709 |
| 5 | St. Lukes Hospital of Kansas City City, KS percent of total billed charges · outpatientfrom % of charges | 2 | $5.5k | $5.5k | $5.5k | 99% | 802–811 | $56 – $11.0k |
| 6 | Barnes Jewish Hospital St. Louis, MO percent of total billed charges · bothfrom % of charges | 6 | $82 | $88 | $38 | 44% | 720 | $1 – $228 |
| 7 | Piedmont Henry Stockbridge, GA percent of total billed charges · bothfrom % of charges | 1 | $55 | $55 | — | — | 640 | $55 – $55 |
| 8 | Wentworth Douglass Hospital Dover, NH other · both | 1 | $109 | $109 | — | — | 480 | $109 – $109 |
| 9 | Piedmont Athens Regional Athens, GA percent of total billed charges · bothfrom % of charges | 1 | $186 | $186 | — | — | 328 | $186 – $186 |
| 10 | North Carolina Baptist Hospital Bermuda Run, NC percent of total billed charges · outpatientfrom % of charges | 4 | $581 | $964 | $921 | 96% | 124–1,240 | $13 – $3.1k |
| 11 | Mayo Clinic Florida Jacksonville, FL facility · percent of total billed charges · bothfrom % of charges | 5 | $4.7k | $7.4k | $6.9k | 93% | 81–261 | $473 – $24.4k |
| 12 | The University of Texas Southwestern Medical Center at Dallas Dallas, TX other · outpatient | 1 | $32.3k | $32.3k | — | — | 78–780 | $32.3k – $32.3k |
| 13 | Mayo Clinic Arizona Phoenix, AZ facility · percent of total billed charges · bothfrom % of charges | 5 | $5.6k | $6.0k | $4.6k | 76% | 67–130 | $623 – $19.3k |
| 14 | ALEGENT CREIGHTON HEALTH Omaha, NE fee schedule · outpatient | 2 | $31 | $31 | $4 | 14% | 58–400 | $26 – $35 |
| 15 | ALEGENT CREIGHTON HEALTH Papillion, NE fee schedule · outpatient | 2 | $31 | $31 | $4 | 14% | 38–380 | $26 – $35 |
| 16 | Saint Alphonsus Regional Medical Center - Boise Boise, ID facility · percent of total billed charges · bothfrom % of charges | 2 | $65 | $228 | $891 | 391% | 35–350 | $1 – $5.4k |
| 17 | PRISMA HEALTH PATEWOOD HOSPITAL GREENVILLE, SC percent of total billed charges · bothfrom % of charges | 3 | $5.5k | $10.2k | $12.6k | 124% | 33 | $29 – $49.5k |
| 18 | Medical Park Hospital LLC Winston-Salem, NC percent of total billed charges · outpatientfrom % of charges | 2 | $19.9k | $19.9k | — | — | 30 | $19.9k – $19.9k |
| 19 | PRISMA HEALTH BAPTIST EASLEY HOSPITAL EASLEY, SC percent of total billed charges · bothfrom % of charges | 3 | $5.6k | $10.8k | $13.5k | 125% | 30 | $29 – $47.9k |
| 20 | PRISMA HEALTH GREENVILLE MEMORIAL HOSPITAL GREENVILLE, SC percent of total billed charges · bothfrom % of charges | 3 | $5.6k | $10.8k | $13.5k | 125% | 30 | $29 – $47.9k |
| 21 | GOOD SAMARITAN HOSPITAL Kearney, NE fee schedule · outpatient | 2 | $31 | $31 | $4 | 14% | 26–260 | $26 – $35 |
| 22 | Mayo Clinic Health System Mankato 56001-4752 facility · percent of total billed charges · bothfrom % of charges | 6 | $8.6k | $8.6k | $6.4k | 74% | 26 | $243 – $18.7k |
| 23 | SAINT ELIZABETH REGIONAL MEDICAL CENTER Lincoln, NE fee schedule · outpatient | 2 | $33 | $33 | $2 | 5% | 26–260 | $32 – $35 |
| 24 | Cumberland County Hospital System Inc Fayetteville, NC facility · percent of total billed charges · outpatientfrom % of charges | 1 | $96.1k | $96.1k | — | — | 21 | $96.1k – $96.1k |
| 25 | North Carolina Baptist Hospital Winston Salem, NC percent of total billed charges · outpatientfrom % of charges | 4 | $115 | $110 | $57 | 51% | 16–160 | $27 – $218 |
← Payers reporting HCPCS Q4116 · Snapshot 20261111T120946Z-9134e7f7