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
$1
Average
$990
Median
$591
High
$14.1k
Each hospital's average MultiPlan rate, under the methodology and billing class chosen below.
37 hospitals; the 90th percentile is 2.9× 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.
Filter by billing methodology
Filter by billing class
39 hospital rates
iThe hospitals that file a MultiPlan 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 | $428 | $428 | $83 | 19% | — | $345 – $511 |
| 3 | Diley Ridge Medical Center Canal Winchester, OH facility · percent of total billed charges · bothfrom % of charges | 1 | $679 | $654 | $255 | 39% | — | $348 – $909 |
| 4 | HCA FLORIDA NORTH FLORIDA HOSPITAL GAINESVILLE, FL percent of total billed charges · outpatientfrom % of charges | 2 | $1 | $1 | $0 | 5% | — | $1 – $1 |
| 5 | Hillsdale Hospital Hillsdale, MI percent of total billed charges · bothfrom % of charges | 1 | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
| 6 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · percent of total billed charges · bothfrom % of charges | 2 | $748 | $720 | $281 | 39% | — | $384 – $1.0k |
| 7 | Johnson Memorial Hospital Stafford Springs, CT facility · percent of total billed charges · bothfrom % of charges | 1 | $403 | $388 | $152 | 39% | — | $207 – $540 |
| 8 | Mercy Fitzgerald Hospital Darby, PA facility · percent of total billed charges · bothfrom % of charges | 1 | $1.1k | $1.1k | $412 | 39% | — | $562 – $1.5k |
| 9 | Mercy Health Hackley Campus Muskogen, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $546 | $526 | $205 | 39% | — | $280 – $731 |
| 10 | Mercy Health Lakeshore Campus Shelby, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $627 | $603 | $236 | 39% | — | $321 – $839 |
| 11 | Mercy Health Saint Marys Rockford, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $473 | $453 | $142 | 31% | — | $273 – $593 |
| 12 | Mercy Health Services-Iowa Corp. Mason City, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $614 | $591 | $231 | 39% | — | $315 – $822 |
| 13 | Mercy Hospital of Franciscan Sisters Inc Oelwein, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $662 | $637 | $249 | 39% | — | $340 – $886 |
| 14 | Mercy Medical Center - Dubuque Dubuque, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $614 | $591 | $231 | 39% | — | $315 – $822 |
| 15 | Mercy Medical Center - Dyersville Dyersville, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $614 | $591 | $231 | 39% | — | $315 – $822 |
| 16 | Mercy Medical Center-Clinton Inc Clinton, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $614 | $591 | $231 | 39% | — | $315 – $822 |
| 17 | Mount Carmel Dublin Dublin, OH facility · percent of total billed charges · bothfrom % of charges | 1 | $776 | $747 | $292 | 39% | — | $398 – $1.0k |
| 18 | Mount Carmel East Reynoldsburg, OH facility · percent of total billed charges · bothfrom % of charges | 1 | $776 | $747 | $292 | 39% | — | $398 – $1.0k |
| 19 | Mount Carmel Grove City Grove City, OH facility · percent of total billed charges · bothfrom % of charges | 1 | $776 | $747 | $292 | 39% | — | $398 – $1.0k |
| 20 | Mount Carmel New Albany Surgical Hospital New Albany, OH facility · percent of total billed charges · bothfrom % of charges | 1 | $776 | $747 | $292 | 39% | — | $398 – $1.0k |
| 21 | Mount Carmel St Ann's Lewis Center, OH facility · percent of total billed charges · bothfrom % of charges | 1 | $776 | $747 | $292 | 39% | — | $398 – $1.0k |
| 22 | Nazareth Hospital Philadelphia, PA facility · percent of total billed charges · bothfrom % of charges | 1 | $1.1k | $1.1k | $412 | 39% | — | $562 – $1.5k |
| 23 | Plymouth Medical Center Plymouth, IN facility · percent of total billed charges · bothfrom % of charges | 1 | $546 | $526 | $205 | 39% | — | $280 – $731 |
| 24 | Saint Francis Hospital and Medical Center Hartford, CT facility · percent of total billed charges · bothfrom % of charges | 1 | $330 | $318 | $124 | 39% | — | $169 – $442 |
| 25 | Saint Marys Hospital Waterbury, CT facility · percent of total billed charges · bothfrom % of charges | 1 | $561 | $540 | $211 | 39% | — | $288 – $751 |
← Payers reporting HCPCS Q4211 · Snapshot 20261111T120946Z-9134e7f7