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
Xcm biologic tissue matrix, per square centimeter (add-on, list separately in addition to primary procedure)
Low
$1
Average
$7.1k
Median
$136
High
$113.1k
Each hospital's average MultiPlan rate, under the methodology and billing class chosen below.
109 hospitals; the 90th percentile is 619.2× 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.
Filter by billing methodology
Filter by billing class
141 hospital rates
iThe hospitals that file a MultiPlan 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 | BURLESON ST. JOSEPH HEALTH CENTER OF CALDWELL, TEXAS Caldwell, TX fee schedule · inpatient | 1 | $24.6k | $24.6k | $6.1k | 25% | — | $18.4k – $30.7k |
| 2 | BURLESON ST. JOSEPH HEALTH CENTER OF CALDWELL, TEXAS Caldwell, TX fee schedule · outpatient | 1 | $24.6k | $24.6k | $6.1k | 25% | — | $18.4k – $30.7k |
| 3 | CHIPPENHAM HOSPITAL RICHMOND, VA percent of total billed charges · outpatientfrom % of charges | 1 | $815 | $815 | — | — | — | $815 – $815 |
| 4 | Capital Health System Inc Trenton, NJ percent of total billed charges · inpatientfrom % of charges | 1 | $113.1k | $113.1k | — | — | — | $113.1k – $113.1k |
| 5 | Capital Health System Inc Trenton, NJ percent of total billed charges · outpatientfrom % of charges | 1 | $113.1k | $113.1k | — | — | — | $113.1k – $113.1k |
| 6 | Capital Health System Inc Browns Mills, NJ percent of total billed charges · inpatientfrom % of charges | 1 | $113.1k | $113.1k | — | — | — | $113.1k – $113.1k |
| 7 | Capital Health System Inc Browns Mills, NJ percent of total billed charges · outpatientfrom % of charges | 1 | $113.1k | $113.1k | — | — | — | $113.1k – $113.1k |
| 8 | Centennial Hills Las Vegas, NV percent of total billed charges · bothfrom % of charges | 1 | $35.0k | $33.4k | $5.3k | 16% | — | $26.2k – $38.9k |
| 9 | Diley Ridge Medical Center Canal Winchester, OH facility · percent of total billed charges · bothfrom % of charges | 1 | $72 | $72 | — | — | — | $72 – $72 |
| 10 | HCA FLORIDA AVENTURA HOSPITAL AVENTURA, FL percent of total billed charges · outpatientfrom % of charges | 2 | $8.6k | $8.6k | $1.1k | 13% | — | $7.2k – $10.2k |
| 11 | HCA FLORIDA FORT WALTON-DESTIN HOSPITAL FT WALTON BEACH, FL percent of total billed charges · outpatientfrom % of charges | 2 | $40 | $40 | $2 | 4% | — | $38 – $42 |
| 12 | HCA FLORIDA NORTH FLORIDA HOSPITAL GAINESVILLE, FL percent of total billed charges · outpatientfrom % of charges | 2 | $1 | $1 | $0 | 5% | — | $1 – $1 |
| 13 | HCA FLORIDA OCALA HOSPITAL OCALA, FL percent of total billed charges · outpatientfrom % of charges | 1 | $75 | $75 | — | — | — | $75 – $75 |
| 14 | HCA FLORIDA OSCEOLA HOSPITAL ORLANDO, FL percent of total billed charges · outpatientfrom % of charges | 4 | $66 | $65 | $4 | 5% | — | $61 – $69 |
| 15 | HCA FLORIDA POINCIANA HOSPITAL Kissimmee, FL percent of total billed charges · outpatientfrom % of charges | 4 | $83 | $83 | $4 | 5% | — | $77 – $87 |
| 16 | HCA FLORIDA TRINITY HOSPITAL TAMPA, FL percent of total billed charges · outpatientfrom % of charges | 2 | $8.9k | $8.9k | $556 | 6% | — | $8.3k – $9.4k |
| 17 | HCA FLORIDA WEST MARION HOSPITAL OCALA, FL percent of total billed charges · outpatientfrom % of charges | 1 | $77 | $77 | — | — | — | $77 – $77 |
| 18 | HCA FLORIDA WESTSIDE HOSPITAL PLANTATION, FL percent of total billed charges · outpatientfrom % of charges | 2 | $3.7k | $3.9k | $2.1k | 54% | — | $1.7k – $6.3k |
| 19 | HENRICO DOCTORS HOSPITAL - FOREST MECHANICSVILLE, VA percent of total billed charges · outpatientfrom % of charges | 1 | $815 | $815 | — | — | — | $815 – $815 |
| 20 | HealthAlliance Hospital Kingston, NY facility · percent of total billed charges · inpatientfrom % of charges | 1 | $4.4k | $4.4k | — | — | — | $4.4k – $4.4k |
| 21 | HealthAlliance Hospital Kingston, NY facility · percent of total billed charges · outpatientfrom % of charges | 1 | $4.4k | $4.4k | — | — | — | $4.4k – $4.4k |
| 22 | Henderson Hospital Henderson, NV percent of total billed charges · bothfrom % of charges | 1 | $35.0k | $33.4k | $5.3k | 16% | — | $26.2k – $38.9k |
| 23 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · percent of total billed charges · bothfrom % of charges | 2 | $79 | $79 | — | — | — | $79 – $79 |
| 24 | Indiana University Health Arnett Inc. Lafayette, IN percent of total billed charges · outpatientfrom % of charges | 2 | $143 | $136 | $72 | 53% | — | $39 – $222 |
| 25 | Indiana University Health Ball Memorial Hospital Inc. Muncie, IN percent of total billed charges · outpatientfrom % of charges | 2 | $143 | $136 | $72 | 53% | — | $39 – $222 |
← Payers reporting HCPCS Q4142 · Snapshot 20261111T120946Z-9134e7f7