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
$0
Average
$556
Median
$169
High
$14.4k
Each hospital's average Blue Cross Blue Shield rate, under the methodology and billing class chosen below.
437 hospitals; the 90th percentile is 12.1× 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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509 hospital rates
iThe hospitals that file a Blue Cross Blue Shield 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 | Mercy Hospital Cassville Knob, MO facility · percent of total billed charges · outpatientfrom % of charges | 7 | $68 | $75 | $22 | 29% | 25 | $57 – $114 |
| 2 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY facility · case rate · outpatient | 4 | $1.7k | $2.2k | $810 | 37% | — | $1.4k – $3.2k |
| 3 | AMH Cath Labs LLC Arlington, TX case rate · outpatient | 1 | $125 | $125 | — | — | — | $125 – $125 |
| 4 | AdventHealth Avista Louisville, CO fee schedule · outpatient | 1 | $134 | $134 | — | — | — | $134 – $134 |
| 5 | AdventHealth Castle Rock Castle Rock, CO fee schedule · outpatient | 1 | $133 | $133 | — | — | — | $133 – $133 |
| 6 | AdventHealth Littleton Littleton, CO fee schedule · outpatient | 1 | $133 | $133 | — | — | — | $133 – $133 |
| 7 | AdventHealth Parker Aurora, CO fee schedule · outpatient | 1 | $133 | $133 | — | — | — | $133 – $133 |
| 8 | AdventHealth Porter Denver, CO fee schedule · outpatient | 1 | $133 | $133 | — | — | — | $133 – $133 |
| 9 | Adventhealth Port Charlotte Port Charlotte, FL fee schedule · outpatient | 1 | $134 | $134 | — | — | — | $134 – $134 |
| 10 | Adventhealth Redmond Rome, GA fee schedule · outpatient | 1 | $133 | $133 | — | — | — | $133 – $133 |
| 11 | Agnesian Healthcare Inc. Fond Du Lac, WI fee schedule · outpatient | 2 | $102 | $102 | $21 | 21% | — | $81 – $123 |
| 12 | Allina Health Systems Shakopee, MN facility · fee schedule · outpatient | 1 | $135 | $135 | — | — | — | $135 – $135 |
| 13 | Allina Health Systems Shakopee, MN facility · other · outpatient | 5 | $112 | $105 | $17 | 17% | — | $75 – $127 |
| 14 | Allina Health Systems MN; 1175 Nininger Road. Hastings, MN facility · fee schedule · outpatient | 1 | $135 | $135 | — | — | — | $135 – $135 |
| 15 | Allina Health Systems MN; 1175 Nininger Road. Hastings, MN facility · other · outpatient | 2 | $109 | $109 | $10 | 9% | — | $99 – $119 |
| 16 | Allina Health Systems Owatonna, MN facility · fee schedule · outpatient | 1 | $133 | $133 | — | — | — | $133 – $133 |
| 17 | Allina Health Systems Owatonna, MN facility · other · outpatient | 5 | $112 | $105 | $17 | 17% | — | $75 – $127 |
| 18 | Allina Health Systems MN 55443; 550 Osborne Road NE. Fridley, MN facility · fee schedule · outpatient | 1 | $135 | $135 | — | — | — | $135 – $135 |
| 19 | Allina Health Systems MN 55443; 550 Osborne Road NE. Fridley, MN facility · other · outpatient | 1 | $99 | $99 | — | — | — | $99 – $99 |
| 20 | Allina Health Systems Cambridge, MN facility · fee schedule · outpatient | 1 | $135 | $135 | — | — | — | $135 – $135 |
| 21 | Allina Health Systems Cambridge, MN facility · other · outpatient | 5 | $112 | $105 | $17 | 17% | — | $75 – $127 |
| 22 | Allina Health Systems Faribualt, MN facility · fee schedule · outpatient | 1 | $134 | $134 | — | — | — | $134 – $134 |
| 23 | Allina Health Systems Faribualt, MN facility · other · outpatient | 5 | $112 | $105 | $17 | 17% | — | $75 – $127 |
| 24 | Allina Health Systems River Falls, WI facility · fee schedule · outpatient | 2 | $98 | $85 | $36 | 43% | — | $24 – $120 |
| 25 | Allina Health Systems Minneapolis, MN facility · fee schedule · outpatient | 1 | $135 | $135 | — | — | — | $135 – $135 |
← Payers reporting HCPCS Q4197 · Snapshot 20261111T120946Z-9134e7f7