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
$112
Average
$2.4k
Median
$298
High
$12.1k
Each hospital's average Medical Mutual rate, under the methodology and billing class chosen below.
58 hospitals; the 90th percentile is 59.2× 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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81 hospital rates
iThe hospitals that file a Medical Mutual 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 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 1 | $119 | $119 | — | — | — | $119 – $119 |
| 2 | Bethesda Hospital Inc. Lebanon, OH facility · fee schedule · outpatient | 1 | $124 | $124 | — | — | — | $124 – $124 |
| 3 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $32 | $114 | $443 | 389% | — | $0 – $2.7k |
| 4 | Catholic Health Initiatives-Iowa Corp West Des Moines, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $32 | $112 | $436 | 391% | — | $0 – $2.7k |
| 5 | Central Community Hospital Elkader, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $67 | $237 | $926 | 391% | — | $0 – $5.6k |
| 6 | Columbus Regional Hospital Columbus, IN percent of total billed charges · bothfrom % of charges | 1 | $10.9k | $10.9k | — | — | — | $10.9k – $10.9k |
| 7 | Covenant Medical Center Inc Waterloo, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $82 | $287 | $1.1k | 391% | — | $0 – $6.8k |
| 8 | Diley Ridge Medical Center Canal Winchester, OH facility · percent of total billed charges · bothfrom % of charges | 1 | $83 | $247 | $907 | 367% | — | $1 – $5.5k |
| 9 | Fisher-Titus Medical Center Norwalk, OH facility · percent of total billed charges · inpatientfrom % of charges | 1 | $2.4k | $2.4k | $1.9k | 80% | — | $472 – $4.2k |
| 10 | Fisher-Titus Medical Center Norwalk, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1.6k | $1.6k | $1.3k | 80% | — | $320 – $2.9k |
| 11 | Mayo Clinic Rochester, MN facility · percent of total billed charges · bothfrom % of charges | 2 | $13.4k | $12.1k | $6.3k | 52% | — | $3.2k – $18.3k |
| 12 | Mayo Clinic Arizona Phoenix, AZ facility · percent of total billed charges · bothfrom % of charges | 3 | $5.5k | $5.9k | $4.5k | 76% | — | $573 – $17.3k |
| 13 | Mayo Clinic Florida Jacksonville, FL facility · percent of total billed charges · bothfrom % of charges | 4 | $4.9k | $8.7k | $8.3k | 96% | — | $502 – $33.8k |
| 14 | Mayo Clinic Health System Mankato 56001-4752 facility · percent of total billed charges · bothfrom % of charges | 1 | $9.4k | $9.1k | $6.7k | 73% | — | $272 – $18.3k |
| 15 | Mayo Clinic Health System Fairmont 56031-4575 facility · percent of total billed charges · bothfrom % of charges | 1 | $3.4k | $3.4k | — | — | — | $3.4k – $3.4k |
| 16 | Mayo Clinic Health System Eau Claire 54703-5270 facility · percent of total billed charges · bothfrom % of charges | 2 | $8.6k | $10.2k | $4.2k | 41% | — | $6.9k – $18.4k |
| 17 | Mayo Clinic Health System Sparta, WI facility · percent of total billed charges · bothfrom % of charges | 3 | $3.4k | $6.2k | $6.4k | 103% | — | $125 – $18.7k |
| 18 | McCullough-Hyde Memorial Hospital, Inc. Oxford, OH facility · fee schedule · outpatient | 1 | $124 | $124 | — | — | — | $124 – $124 |
| 19 | Mercy Health Hackley Campus Muskogen, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $65 | $215 | $836 | 389% | — | $1 – $5.2k |
| 20 | Mercy Health Lakeshore Campus Shelby, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $73 | $249 | $962 | 387% | — | $1 – $5.9k |
| 21 | Mercy Health Saint Marys Rockford, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $68 | $172 | $559 | 326% | — | $1 – $3.4k |
| 22 | Mercy Health Services-Iowa Corp. Mason City, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $48 | $169 | $660 | 391% | — | $0 – $4.0k |
| 23 | Mercy Hospital of Franciscan Sisters Inc Oelwein, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $84 | $295 | $1.2k | 391% | — | $0 – $7.0k |
| 24 | Mercy Medical Center - Dubuque Dubuque, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $76 | $268 | $1.1k | 391% | — | $0 – $6.4k |
| 25 | Mercy Medical Center - Dyersville Dyersville, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $76 | $266 | $1.0k | 391% | — | $0 – $6.3k |
← Payers reporting HCPCS Q4116 · Snapshot 20261111T120946Z-9134e7f7