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
$1
Average
$626
Median
$56
High
$7.9k
Each hospital's average Medicaid rate, under the methodology and billing class chosen below.
17 hospitals; the 90th percentile is 781.7× 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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17 hospital rates
iThe hospitals that file a Medicaid 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 | CATHOLIC HEALTH INITIATIVES COLORADO Salt Lake City, UT fee schedule · outpatient | 1 | $127 | $127 | — | — | — | $127 – $127 |
| 2 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH CARMEL CARMEL, IN fee schedule · both | 2 | $56 | $56 | $5 | 9% | — | $51 – $61 |
| 3 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH DYER DYER, IN fee schedule · both | 14 | $51 | $53 | $4 | 8% | — | $51 – $61 |
| 4 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH INDIANAPOLIS INDIANAPOLIS, IN fee schedule · both | 16 | $51 | $53 | $4 | 8% | — | $51 – $61 |
| 5 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH LAFAYETTE LAFAYETTE, IN fee schedule · both | 2 | $56 | $56 | $5 | 9% | — | $51 – $61 |
| 6 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH MOORESVILLE MOORESVILLE, IN fee schedule · both | 2 | $56 | $56 | $5 | 9% | — | $51 – $61 |
| 7 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH MUNSTER MUNSTER, IN fee schedule · both | 2 | $56 | $56 | $5 | 9% | — | $51 – $61 |
| 8 | Geisinger Community Medical Center Scranton, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 9 | Geisinger Jersey Shore Hospital Jersey Shore, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 10 | Geisinger Lewistown Hospital Lewistown, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 11 | Geisinger Medical Center Muncy, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 12 | Geisinger Wyoming Valley Wilkes-Barre, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 13 | Hospital Authority of Colquitt County Moultrie, GA fee schedule · both | 1 | $333 | $333 | $10 | 3% | — | $323 – $343 |
| 14 | Lowell General Hospital Lowell, MA percent of total billed charges · bothfrom % of charges | 1 | $200 | $200 | — | — | — | $200 – $200 |
| 15 | Overlook Medical Center Summit, NJ percent of total billed charges · bothfrom % of charges | 1 | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 16 | Ste. Genevieve County Memorial Hospital Ste. Genevieve, MO percent of total billed charges · outpatientfrom % of charges | 1 | $7.9k | $7.9k | — | — | — | $7.9k – $7.9k |
| 17 | TWIN CITIES COMMUNITY HOSPITAL INC Templeton, CA fee schedule · outpatient | 1 | $341 | $341 | — | — | — | $341 – $341 |
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