Cygnus matrix, per square centimeter

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

HC (SUP SHELL Q4199) CYGNUS MATRIX, PER SQ CM

Tricare pricing summary

Low

$109

Average

$509

Median

$127

High

$2.0k

Tricare rate distribution

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30 hospital rates

#		Plans
1	CLAIBORNE MEDICAL CENTER Tazewell, TN fee schedule · outpatient	1	$121	$121	—	—	—	$121 – $121
2	CUMBERLAND MEDICAL CENTER, INC. Crossville, TN fee schedule · outpatient	1	$121	$121	—	—	—	$121 – $121
3	Canton-Potsdam Hospital Potsdam, NY facility · fee schedule · outpatient	1	$109	$109	—	—	—	$109 – $109
4	CentraState Medical Center Freehold Township, NJ other · outpatient	2	$2.0k	$2.0k	—	—	—	$2.0k – $2.0k
5	Central Maine Medical Center Lewiston, ME fee schedule · outpatient	1	$127	$127	—	—	—	$127 – $127
6	Chilton Medical Center Pompton Plains, NJ other · outpatient	2	$2.0k	$2.0k	—	—	—	$2.0k – $2.0k
7	Ellis Hospital NY 12308; 2210 Troy Schenectady Road Niskayuna, NY facility · fee schedule · outpatient	1	$127	$127	—	—	—	$127 – $127
8	FORT LOUDOUN MEDICAL CENTER Lenoir City, TN fee schedule · outpatient	1	$113	$113	—	—	—	$113 – $113
9	FORT SANDERS REGIONAL MEDICAL CENTER Knoxville, TN fee schedule · outpatient	1	$113	$113	—	—	—	$113 – $113
10	Hackettstown Medical Center Hackettstown, NJ other · outpatient	2	$2.0k	$2.0k	—	—	—	$2.0k – $2.0k
11	Kaleida Health Buffalo, NY fee schedule · outpatient	1	$148	$148	—	—	—	$148 – $148
12	Kaweah Health Medical Center Visalia, CA facility · fee schedule · outpatient	1	$127	$127	—	—	—	$127 – $127
13	Kaweah Health Mental Health Hospital Visalia, CA facility · fee schedule · outpatient	1	$464	$464	—	—	—	$464 – $464
14	LECONTE MEDICAL CENTER Sevierville, TN fee schedule · outpatient	1	$121	$121	—	—	—	$121 – $121
15	METHODIST MEDICAL CENTER OF OAK RIDGE Oak Ridge, TN fee schedule · outpatient	1	$113	$113	—	—	—	$113 – $113
16	MORRISTOWN HAMBLEN HOSPITAL ASSOCIATION Morristown, TN fee schedule · outpatient	1	$113	$113	—	—	—	$113 – $113
17	Morristown Medical Center Morristown, NJ other · outpatient	2	$2.0k	$2.0k	—	—	—	$2.0k – $2.0k
18	Newark-Wayne Community Hospital Newark, NY facility · fee schedule · outpatient	1	$121	$121	—	—	—	$121 – $121
19	Newton Medical Center Newton, NJ other · outpatient	2	$2.0k	$2.0k	—	—	—	$2.0k – $2.0k
20	Northside Hospital, Inc. Lawrenceville, GA fee schedule · outpatient	1	$127	$127	—	—	—	$127 – $127
21	Northside Hospital, Inc. Atlanta, GA fee schedule · outpatient	1	$127	$127	—	—	—	$127 – $127
22	Northside Hospital, Inc. Cumming, GA fee schedule · outpatient	1	$127	$127	—	—	—	$127 – $127
23	Northside Hospital, Inc. Duluth, GA fee schedule · outpatient	1	$127	$127	—	—	—	$127 – $127
24	Northside Hospital, Inc. Canton, GA fee schedule · outpatient	1	$127	$127	—	—	—	$127 – $127
25	Overlook Medical Center Summit, NJ other · outpatient	2	$2.0k	$2.0k	—	—	—	$2.0k – $2.0k