Matrion skin substitute, 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

ALLOGRAFT PLACENTAL FENESTR SHEET 2X3CM (6 SQ CM)

Devoted pricing summary

Low

$116

Average

$126

Median

$125

High

$143

Devoted rate distribution

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80 hospital rates

#		Plans
1	Adventhealth Port Charlotte Port Charlotte, FL fee schedule · outpatient	1	$139	$139	—	—	—	$139 – $139
2	Adventhealth Redmond Rome, GA fee schedule · outpatient	1	$136	$136	—	—	—	$136 – $136
3	Boulder Community Health Lafayette, CO facility · case rate · outpatient	1	$137	$137	—	—	—	$137 – $137
4	Boulder Community Health Lafayette, CO professional · fee schedule · both	1	$135	$135	—	—	—	$135 – $135
5	Bryn Mawr Rehabilitation Hospital Malvern, PA facility · fee schedule · outpatient	1	$127	$127	—	—	—	$127 – $127
6	CATHOLIC HEALTH INIATIVES COLORADO Westminster, CO fee schedule · outpatient	1	$125	$125	—	—	—	$125 – $125
7	CATHOLIC HEALTH INITIATIVES COLORADO Pueblo, CO fee schedule · outpatient	1	$125	$125	—	—	—	$125 – $125
8	CATHOLIC HEALTH INITIATIVES COLORADO Colorado Springs, CO fee schedule · outpatient	1	$125	$125	—	—	—	$125 – $125
9	CATHOLIC HEALTH INITIATIVES COLORADO Frisco, CO fee schedule · outpatient	1	$125	$125	—	—	—	$125 – $125
10	CATHOLIC HEALTH INITIATIVES COLORADO Colorado Springs, CO fee schedule · outpatient	1	$125	$125	—	—	—	$125 – $125
11	CATHOLIC HEALTH INITIATIVES COLORADO Fort Morgan, CO fee schedule · outpatient	1	$125	$125	—	—	—	$125 – $125
12	CLAIBORNE MEDICAL CENTER Tazewell, TN fee schedule · outpatient	2	$127	$127	—	—	—	$127 – $127
13	CLEVELAND CLINIC AVON HOSPITAL Avon, OH facility · fee schedule · outpatient	1	$118	$118	—	—	—	$118 – $118
14	CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Mentor, OH facility · fee schedule · outpatient	1	$118	$118	—	—	—	$118 – $118
15	CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Euclid, OH facility · fee schedule · outpatient	1	$118	$118	—	—	—	$118 – $118
16	CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Warrensville Heights, OH facility · fee schedule · outpatient	1	$118	$118	—	—	—	$118 – $118
17	CUMBERLAND MEDICAL CENTER, INC. Crossville, TN fee schedule · outpatient	2	$127	$127	—	—	—	$127 – $127
18	Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · fee schedule · outpatient	2	$143	$143	—	—	—	$143 – $143
19	East Cooper Medical Center LLC Mt Pleasant, SC fee schedule · outpatient	2	$116	$116	—	—	—	$116 – $116
20	FORT LOUDOUN MEDICAL CENTER Lenoir City, TN fee schedule · outpatient	2	$119	$119	—	—	—	$119 – $119
21	FORT SANDERS REGIONAL MEDICAL CENTER Knoxville, TN fee schedule · outpatient	2	$119	$119	—	—	—	$119 – $119
22	Fairview Hospital Cleveland, OH facility · fee schedule · outpatient	1	$118	$118	—	—	—	$118 – $118
23	Hilton Head Medical Center LLC Hilton Head Island, SC fee schedule · both	2	$116	$116	—	—	—	$116 – $116
24	Houston Methodist Cypress Hospital Cypress, TX fee schedule · outpatient	1	$134	$134	—	—	—	$134 – $134
25	INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL facility · fee schedule · outpatient	1	$143	$143	—	—	—	$143 – $143

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HCPCS Q4201