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
$1
Average
$3.9k
Median
$355
High
$164.9k
Each hospital's average Cigna rate, under the methodology and billing class chosen below.
1130 hospitals; the 90th percentile is 230.3× 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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1,666 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 | Brigham and Women's Faulkner Hospital Boston, MA percent of total billed charges · outpatientfrom % of charges | 1 | $2.9k | $2.8k | $2.0k | 71% | 9,212 | $30 – $7.3k |
| 2 | Piedmont Atlanta Atlanta, GA percent of total billed charges · bothfrom % of charges | 2 | $15.3k | $17.3k | $11.4k | 66% | 7,605 | $602 – $44.5k |
| 3 | Saint Luke’s South Hospital, Inc Leawood, KS percent of total billed charges · bothfrom % of charges | 10 | $42 | $63 | $81 | 130% | 4,640 | $10 – $714 |
| 4 | Saint Luke’s South Hospital, Inc Leawood, KS percent of total billed charges · outpatientfrom % of charges | 1 | $66 | $66 | — | — | 4,640 | $66 – $66 |
| 5 | Massachusetts General Hospital Boston, MA percent of total billed charges · outpatientfrom % of charges | 2 | $3.6k | $4.3k | $3.3k | 78% | 3,641 | $34 – $16.0k |
| 6 | Piedmont Henry Stockbridge, GA percent of total billed charges · bothfrom % of charges | 2 | $15.3k | $17.3k | $11.4k | 66% | 3,572 | $602 – $44.5k |
| 7 | Brigham and Women's Hospital Boston, MA percent of total billed charges · outpatientfrom % of charges | 2 | $3.9k | $4.6k | $3.5k | 77% | 1,585 | $34 – $16.5k |
| 8 | University of Arkansas for Medical Sciences Little Rock, AR facility · percent of total billed charges · outpatientfrom % of charges | 2 | $11.2k | $11.2k | $6.4k | 57% | 1,544 | $4.8k – $17.6k |
| 9 | St. Lukes Hospital of Kansas City City, KS percent of total billed charges · bothfrom % of charges | 10 | $44 | $69 | $92 | 135% | 1,490 | $20 – $658 |
| 10 | St. Lukes Hospital of Kansas City City, KS percent of total billed charges · outpatientfrom % of charges | 2 | $30 | $30 | $8 | 26% | 1,490 | $22 – $38 |
| 11 | Piedmont Fayette Fayetteville, GA percent of total billed charges · bothfrom % of charges | 2 | $15.3k | $17.3k | $11.4k | 66% | 1,280 | $602 – $44.5k |
| 12 | Newton Wellesley Hospital Newton, MA percent of total billed charges · outpatientfrom % of charges | 1 | $3.1k | $3.6k | $2.7k | 76% | 480 | $30 – $11.6k |
| 13 | Saint Luke’s East Hospital Summit, MO percent of total billed charges · bothfrom % of charges | 10 | $44 | $70 | $106 | 151% | 400 | $14 – $714 |
| 14 | Saint Luke’s East Hospital Summit, MO percent of total billed charges · outpatientfrom % of charges | 1 | $21 | $21 | — | — | 400 | $21 – $21 |
| 15 | Saint Luke’s North Hospital Smithville, MO percent of total billed charges · bothfrom % of charges | 11 | $44 | $77 | $125 | 162% | 320 | $10 – $752 |
| 16 | Saint Luke’s North Hospital Smithville, MO percent of total billed charges · outpatientfrom % of charges | 1 | $44 | $44 | — | — | 320 | $44 – $44 |
| 17 | Saint Luke’s North Hospital City, KS percent of total billed charges · bothfrom % of charges | 11 | $44 | $77 | $125 | 162% | 320 | $10 – $752 |
| 18 | Saint Luke’s North Hospital City, KS percent of total billed charges · outpatientfrom % of charges | 1 | $44 | $44 | — | — | 320 | $44 – $44 |
| 19 | University of Wisconsin Hospital and Clinics Authority WI 53718; 1675 Highland Ave Madison, WI percent of total billed chargesfrom % of charges | 1 | $2.0k | $4.0k | $3.2k | 80% | 320 | $1.2k – $9.9k |
| 20 | Pitt County Memorial Hospital, Inc. Greenville, NC percent of total billed charges · bothfrom % of charges | 8 | $129 | $131 | $25 | 19% | 268 | $89 – $225 |
| 21 | Pitt County Memorial Hospital, Inc. Washington, NC percent of total billed charges · bothfrom % of charges | 8 | $129 | $131 | $25 | 19% | 268 | $89 – $225 |
| 22 | Piedmont Newnan Newnan, GA percent of total billed charges · bothfrom % of charges | 2 | $15.3k | $17.3k | $11.4k | 66% | 264 | $602 – $44.5k |
| 23 | The University of Texas Southwestern Medical Center at Dallas Dallas, TX percent of total billed charges · outpatientfrom % of charges | 1 | $10.9k | $11.3k | $8.4k | 74% | 78–780 | $488 – $48.5k |
| 24 | Vanderbilt University Medical Center Nashville, TN percent of total billed charges · bothfrom % of charges | 5 | $2.8k | $4.5k | $4.7k | 105% | 74–740 | $47 – $20.6k |
| 25 | North Carolina Baptist Hospital Bermuda Run, NC percent of total billed charges · outpatientfrom % of charges | 3 | $970 | $1.6k | $1.6k | 102% | 62–620 | $22 – $6.1k |
← Payers reporting HCPCS Q4116 · Snapshot 20261111T120946Z-9134e7f7