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
$3.0k
Median
$264
High
$41.2k
Each hospital's average UnitedHealthcare rate, under the methodology and billing class chosen below.
1255 hospitals; the 90th percentile is 159.6× 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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2,034 hospital rates
iThe hospitals that file a UnitedHealthcare 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 | St Luke's Regional Medical Center, LTD Mountain Home, ID percent of total billed charges · bothfrom % of charges | 1 | $55 | $81 | $55 | 68% | 4,170 | $39 – $185 |
| 2 | St. Lukes Hospital of Kansas City City, KS percent of total billed charges · bothfrom % of charges | 13 | $42 | $60 | $77 | 128% | 1,109–1,730 | $18 – $423 |
| 3 | University of Wisconsin Hospital and Clinics Authority WI 53718; 1675 Highland Ave Madison, WI percent of total billed chargesfrom % of charges | 3 | $2.8k | $4.5k | $3.7k | 83% | 1,090 | $1.1k – $14.0k |
| 4 | St. Lukes Hospital of Kansas City City, KS percent of total billed charges · outpatientfrom % of charges | 4 | $7.3k | $5.7k | $3.3k | 58% | 1,043–1,070 | $39 – $8.0k |
| 5 | GULF COAST MEDICAL CENTER FORT MYERS, FL facility · percent of total billed charges · bothfrom % of charges | 1 | $127 | $8.9k | $12.6k | 141% | 948 | $39 – $39.9k |
| 6 | Saint Alphonsus Regional Medical Center - Boise Boise, ID facility · percent of total billed charges · bothfrom % of charges | 1 | $91 | $305 | $1.2k | 392% | 640 | $2 – $7.6k |
| 7 | HEALTHPARK MEDICAL CENTER FORT MYERS, FL facility · percent of total billed charges · bothfrom % of charges | 1 | $127 | $8.9k | $12.6k | 141% | 370 | $39 – $39.9k |
| 8 | Saint Luke’s North Hospital Smithville, MO percent of total billed charges · bothfrom % of charges | 14 | $41 | $68 | $110 | 161% | 335–470 | $11 – $940 |
| 9 | Saint Luke’s North Hospital City, KS percent of total billed charges · bothfrom % of charges | 14 | $41 | $68 | $110 | 161% | 335–470 | $11 – $940 |
| 10 | Saint Luke’s North Hospital Smithville, MO percent of total billed charges · outpatientfrom % of charges | 2 | $3.8k | $3.8k | $3.7k | 99% | 321–330 | $39 – $7.5k |
| 11 | Saint Luke’s North Hospital City, KS percent of total billed charges · outpatientfrom % of charges | 2 | $3.8k | $3.8k | $3.7k | 99% | 321–330 | $39 – $7.5k |
| 12 | University of New Mexico Hospital | UNM Sandoval Regional Medical Center - A Campus of UNM Hospital Rio Rancho, NM facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1.4k | $1.4k | — | — | 149 | $1.4k – $1.4k |
| 13 | METHODIST LEBONHEUR GERMANTOWN HOSP GERMANTOWN, TN percent of total billed charges · bothfrom % of charges | 7 | $3.8k | $4.0k | $3.1k | 76% | 78–780 | $127 – $11.9k |
| 14 | The University of Texas Southwestern Medical Center at Dallas Dallas, TX percent of total billed charges · outpatientfrom % of charges | 2 | $5.7k | $7.6k | $7.4k | 98% | 78–780 | $98 – $48.8k |
| 15 | Saint Luke’s South Hospital, Inc Leawood, KS percent of total billed charges · bothfrom % of charges | 13 | $40 | $53 | $64 | 120% | 70–700 | $11 – $423 |
| 16 | Regions Hospital St. Paul, MN facility · percent of total billed charges · bothfrom % of charges | 1 | $1.7k | $4.7k | $6.8k | 143% | 69–690 | $25 – $36.6k |
| 17 | Tucson Medical Center Tucson, AZ facility · other · outpatient | 1 | $11.4k | $11.4k | — | — | 65–650 | $11.4k – $11.4k |
| 18 | Tucson Medical Center Tucson, AZ facility · other · outpatient | 1 | $11.4k | $11.4k | — | — | 65–650 | $11.4k – $11.4k |
| 19 | Mercy Health Hackley Campus Muskogen, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $72 | $240 | $933 | 389% | 36–360 | $1 – $5.8k |
| 20 | Sanford USD Medical Center Sioux Falls, SD percent of total billed charges · outpatientfrom % of charges | 2 | $121 | $157 | $114 | 73% | 35–350 | $59 – $543 |
| 21 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · percent of total billed charges · bothfrom % of charges | 4 | $67 | $232 | $946 | 408% | 34–340 | $0 – $7.6k |
| 22 | North Carolina Baptist Hospital Bermuda Run, NC percent of total billed charges · outpatientfrom % of charges | 3 | $634 | $986 | $921 | 93% | 31–310 | $16 – $2.8k |
| 23 | Mayo Clinic Arizona Phoenix, AZ facility · percent of total billed charges · bothfrom % of charges | 2 | $5.1k | $5.1k | $3.8k | 75% | 29–92 | $562 – $13.0k |
| 24 | Mayo Clinic Florida Jacksonville, FL facility · percent of total billed charges · bothfrom % of charges | 2 | $4.3k | $6.6k | $6.1k | 93% | 20–200 | $464 – $20.9k |
| 25 | Lakeview Hospital Stillwater, MN facility · percent of total billed charges · bothfrom % of charges | 1 | $5.0k | $6.1k | $3.4k | 56% | 19–190 | $2.3k – $13.0k |
← Payers reporting HCPCS Q4116 · Snapshot 20261111T120946Z-9134e7f7