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
HC Implant Graft Purified Collagen Matrix Phmb Antimicrobial Extra Fenestrated Puraply 25cm 515-071 Puraplyam Xt-Com4.91x4.91ef
Low
$36
Average
$849
Median
$106
High
$2.1k
Each hospital's average Amerihealth Caritas rate, under the methodology and billing class chosen below.
16 hospitals; the 90th percentile is 47.3× 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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16 hospital rates
iThe hospitals that file a Amerihealth Caritas 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 | Appalachian Regional Behavioral Health Hospital Linville, NC facility · percent of total billed charges · outpatientfrom % of charges | 1 | $50 | $50 | — | — | — | $50 – $50 |
| 2 | BRFHH MONROE, LLC Monroe, LA other · outpatient | 1 | $36 | $36 | — | — | — | $36 – $36 |
| 3 | CentraState Medical Center Freehold Township, NJ other · outpatient | 1 | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
| 4 | Charles A. Cannon Jr. Memorial Hospital, Inc Cannon, NC facility · percent of total billed charges · outpatientfrom % of charges | 1 | $79 | $79 | — | — | — | $79 – $79 |
| 5 | Chilton Medical Center Pompton Plains, NJ other · outpatient | 1 | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
| 6 | Fairfield Medical Center 401 N Ewing St facility · fee schedule · outpatient | 1 | $74 | $74 | — | — | — | $74 – $74 |
| 7 | Hackettstown Medical Center Hackettstown, NJ other · outpatient | 1 | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
| 8 | Lowell General Hospital Lowell, MA percent of total billed charges · bothfrom % of charges | 1 | $70 | $70 | — | — | — | $70 – $70 |
| 9 | Morristown Medical Center Morristown, NJ other · outpatient | 1 | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
| 10 | Newton Medical Center Newton, NJ other · outpatient | 1 | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
| 11 | OCHSNER LSU HEALTH SHREVEPORT - ST. MARY MEDICAL CENTER, LLC Shreveport, LA other · outpatient | 1 | $45 | $45 | — | — | — | $45 – $45 |
| 12 | Overlook Medical Center Summit, NJ other · outpatient | 1 | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
| 13 | UNIVERSITY HEALTH SHREVEPORT, LLC Shreveport, LA other · outpatient | 1 | $45 | $45 | — | — | — | $45 – $45 |
| 14 | Uniontown Hospital Uniontown, PA facility · other · outpatient | 1 | $133 | $133 | — | — | — | $133 – $133 |
| 15 | Watauga Medical Center, Inc Boone, NC facility · percent of total billed charges · outpatientfrom % of charges | 1 | $49 | $49 | — | — | — | $49 – $49 |
| 16 | Weirton Medical Center Inc Weirton, WV facility · other · outpatient | 1 | $137 | $137 | — | — | — | $137 – $137 |
← Payers reporting HCPCS Q4197 · Snapshot 20261111T120946Z-9134e7f7