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
$335
Average
$452
Median
$437
High
$628
Each hospital's average Medcost rate, under the methodology and billing class chosen below.
15 hospitals; the 90th percentile is 1.4× 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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16 hospital rates
iThe hospitals that file a Medcost 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 | Children's Hospital of the King's Daughters Norfolk, VA facility · percent of total billed charges · inpatientfrom % of charges | 1 | $428 | $428 | $83 | 19% | — | $345 – $511 |
| 2 | Children's Hospital of the King's Daughters Norfolk, VA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $395 | $395 | $77 | 19% | — | $319 – $472 |
| 3 | Diley Ridge Medical Center Canal Winchester, OH facility · percent of total billed charges · bothfrom % of charges | 1 | $397 | $382 | $149 | 39% | — | $204 – $531 |
| 4 | Mercy Health Hackley Campus Muskogen, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $574 | $553 | $216 | 39% | — | $294 – $768 |
| 5 | Mercy Health Lakeshore Campus Shelby, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $652 | $628 | $245 | 39% | — | $334 – $873 |
| 6 | Mercy Health Saint Marys Rockford, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $493 | $472 | $148 | 31% | — | $284 – $618 |
| 7 | Mount Carmel Dublin Dublin, OH facility · percent of total billed charges · bothfrom % of charges | 1 | $454 | $437 | $171 | 39% | — | $233 – $607 |
| 8 | Mount Carmel East Reynoldsburg, OH facility · percent of total billed charges · bothfrom % of charges | 1 | $454 | $437 | $171 | 39% | — | $233 – $607 |
| 9 | Mount Carmel Grove City Grove City, OH facility · percent of total billed charges · bothfrom % of charges | 1 | $454 | $437 | $171 | 39% | — | $233 – $607 |
| 10 | Mount Carmel New Albany Surgical Hospital New Albany, OH facility · percent of total billed charges · bothfrom % of charges | 1 | $454 | $437 | $171 | 39% | — | $233 – $607 |
| 11 | Mount Carmel St Ann's Lewis Center, OH facility · percent of total billed charges · bothfrom % of charges | 1 | $454 | $437 | $171 | 39% | — | $233 – $607 |
| 12 | St Joseph Mercy Ann Arbor Ypsilanti, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $405 | $388 | $114 | 30% | — | $240 – $501 |
| 13 | St Joseph Mercy Chelsea Chelsea, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $350 | $335 | $99 | 30% | — | $207 – $432 |
| 14 | St Joseph Mercy Livingston Hospital | Trinity Health Medical Center - Brighton Brighton, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $429 | $410 | $121 | 30% | — | $254 – $529 |
| 15 | St Joseph Mercy Oakland Pontiac, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $519 | $499 | $195 | 39% | — | $266 – $694 |
| 16 | St Mary Mercy Livonia Livonia, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $540 | $520 | $203 | 39% | — | $277 – $722 |
← Payers reporting HCPCS Q4211 · Snapshot 20261111T120946Z-9134e7f7