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 Matrix Amnion 3x4cm Thick <12 Sq Cm>
Low
$118
Average
$401
Median
$297
High
$8.6k
Each hospital's average Cigna rate, under the methodology and billing class chosen below.
137 hospitals; the 90th percentile is 4.9× 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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141 hospital rates
iThe hospitals that file a Cigna 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 | St Luke's Magic Valley Regional Medical Center, LTD Jerome, ID percent of total billed charges · bothfrom % of charges | 1 | $416 | $416 | — | — | 1–10 | $416 – $416 |
| 2 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · fee schedule · outpatient | 1 | $121 | $121 | — | — | — | $121 – $121 |
| 3 | Boulder Community Health Lafayette, CO professional · fee schedule · both | 1 | $127 | $127 | — | — | — | $127 – $127 |
| 4 | Brunswick Community Hospital, LLC Bolivia, NC fee schedule · outpatient | 1 | $137 | $137 | — | — | — | $137 – $137 |
| 5 | CATHOLIC HEALTH INIATIVES COLORADO Westminster, CO fee schedule · outpatient | 1 | $125 | $125 | — | — | — | $125 – $125 |
| 6 | CATHOLIC HEALTH INITIATIVES COLORADO Pueblo, CO fee schedule · outpatient | 1 | $125 | $125 | — | — | — | $125 – $125 |
| 7 | CATHOLIC HEALTH INITIATIVES COLORADO Colorado Springs, CO fee schedule · outpatient | 1 | $125 | $125 | — | — | — | $125 – $125 |
| 8 | CATHOLIC HEALTH INITIATIVES COLORADO Frisco, CO fee schedule · outpatient | 1 | $125 | $125 | — | — | — | $125 – $125 |
| 9 | CATHOLIC HEALTH INITIATIVES COLORADO Durango, 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 | 8 | $144 | $137 | $8 | 6% | — | $127 – $144 |
| 13 | CLEVELAND CLINIC AVON HOSPITAL Avon, OH facility · fee schedule · outpatient | 1 | $121 | $121 | — | — | — | $121 – $121 |
| 14 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Mentor, OH facility · fee schedule · outpatient | 1 | $121 | $121 | — | — | — | $121 – $121 |
| 15 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Euclid, OH facility · fee schedule · outpatient | 1 | $121 | $121 | — | — | — | $121 – $121 |
| 16 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Warrensville Heights, OH facility · fee schedule · outpatient | 1 | $121 | $121 | — | — | — | $121 – $121 |
| 17 | CLOVIS COMMUNITY MEDICAL CENTER Clovis, CA facility · case rate · outpatient | 2 | $160 | $160 | — | — | — | $160 – $160 |
| 18 | COMMONSPIRIT KANSAS, INC. Dodge City, KS fee schedule · outpatient | 1 | $125 | $125 | — | — | — | $125 – $125 |
| 19 | COMMONSPIRIT KANSAS, INC. Garden City, KS fee schedule · outpatient | 1 | $125 | $125 | — | — | — | $125 – $125 |
| 20 | CUMBERLAND MEDICAL CENTER, INC. Crossville, TN fee schedule · outpatient | 8 | $144 | $137 | $8 | 6% | — | $127 – $144 |
| 21 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $409 | $394 | $154 | 39% | — | $210 – $548 |
| 22 | Catholic Health Initiatives-Iowa Corp West Des Moines, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $409 | $394 | $154 | 39% | — | $210 – $548 |
| 23 | Central Community Hospital Elkader, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $669 | $644 | $251 | 39% | — | $343 – $895 |
| 24 | Children's Hospital of the King's Daughters Norfolk, VA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $309 | $309 | $60 | 19% | — | $249 – $369 |
| 25 | Cleveland Clinic Mercy Hospital Canton, OH facility · fee schedule · outpatient | 1 | $121 | $121 | — | — | — | $121 – $121 |
← Payers reporting HCPCS Q4211 · Snapshot 20261111T120946Z-9134e7f7