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
VIA MATRIX, PER SQ CM
Low
$0
Average
$4.1k
Median
$140
High
$97.5k
Each hospital's average Aetna rate, under the methodology and billing class chosen below.
397 hospitals; the 90th percentile is 18.0× 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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421 hospital rates
iThe hospitals that file a Aetna 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 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · fee schedule · outpatient | 3 | $1.6k | $2.2k | $2.0k | 90% | — | $118 – $4.8k |
| 2 | Acadia Hospital Bangor, ME professional · fee schedule · outpatient | 2 | $1.2k | $1.2k | $330 | 27% | — | $880 – $1.5k |
| 3 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 1 | $119 | $119 | — | — | — | $119 – $119 |
| 4 | AdventHealth Avista Louisville, CO fee schedule · outpatient | 1 | $133 | $133 | — | — | — | $133 – $133 |
| 5 | AdventHealth Castle Rock Castle Rock, CO fee schedule · outpatient | 1 | $131 | $131 | — | — | — | $131 – $131 |
| 6 | AdventHealth Littleton Littleton, CO fee schedule · outpatient | 1 | $131 | $131 | — | — | — | $131 – $131 |
| 7 | AdventHealth Parker Aurora, CO fee schedule · outpatient | 1 | $131 | $131 | — | — | — | $131 – $131 |
| 8 | AdventHealth Porter Denver, CO fee schedule · outpatient | 1 | $131 | $131 | — | — | — | $131 – $131 |
| 9 | Allina Health Systems Shakopee, MN facility · fee schedule · outpatient | 1 | $122 | $122 | — | — | — | $122 – $122 |
| 10 | Allina Health Systems Shakopee, MN facility · percent of total billed charges · inpatientfrom % of charges | 3 | $340 | $803 | $1.0k | 126% | — | $184 – $3.3k |
| 11 | Allina Health Systems Shakopee, MN facility · percent of total billed charges · outpatientfrom % of charges | 3 | $340 | $805 | $1.0k | 126% | — | $184 – $3.3k |
| 12 | Allina Health Systems MN; 1175 Nininger Road. Hastings, MN facility · fee schedule · outpatient | 1 | $122 | $122 | — | — | — | $122 – $122 |
| 13 | Allina Health Systems MN; 1175 Nininger Road. Hastings, MN facility · percent of total billed charges · outpatientfrom % of charges | 3 | $271 | $679 | $875 | 129% | — | $146 – $3.0k |
| 14 | Allina Health Systems Owatonna, MN facility · fee schedule · outpatient | 1 | $122 | $122 | — | — | — | $122 – $122 |
| 15 | Allina Health Systems Owatonna, MN facility · percent of total billed charges · inpatientfrom % of charges | 3 | $340 | $803 | $1.0k | 126% | — | $184 – $3.3k |
| 16 | Allina Health Systems Owatonna, MN facility · percent of total billed charges · outpatientfrom % of charges | 3 | $340 | $805 | $1.0k | 126% | — | $184 – $3.3k |
| 17 | Allina Health Systems MN 55443; 550 Osborne Road NE. Fridley, MN facility · fee schedule · outpatient | 1 | $122 | $122 | — | — | — | $122 – $122 |
| 18 | Allina Health Systems MN 55443; 550 Osborne Road NE. Fridley, MN facility · percent of total billed charges · outpatientfrom % of charges | 3 | $271 | $679 | $875 | 129% | — | $146 – $3.0k |
| 19 | Allina Health Systems Cambridge, MN facility · fee schedule · outpatient | 1 | $122 | $122 | — | — | — | $122 – $122 |
| 20 | Allina Health Systems Cambridge, MN facility · percent of total billed charges · inpatientfrom % of charges | 3 | $340 | $803 | $1.0k | 126% | — | $184 – $3.3k |
| 21 | Allina Health Systems Cambridge, MN facility · percent of total billed charges · outpatientfrom % of charges | 3 | $340 | $805 | $1.0k | 126% | — | $184 – $3.3k |
| 22 | Allina Health Systems Faribualt, MN facility · fee schedule · outpatient | 1 | $122 | $122 | — | — | — | $122 – $122 |
| 23 | Allina Health Systems Faribualt, MN facility · percent of total billed charges · inpatientfrom % of charges | 3 | $340 | $803 | $1.0k | 126% | — | $184 – $3.3k |
| 24 | Allina Health Systems Faribualt, MN facility · percent of total billed charges · outpatientfrom % of charges | 3 | $340 | $805 | $1.0k | 126% | — | $184 – $3.3k |
| 25 | Allina Health Systems River Falls, WI facility · fee schedule · outpatient | 1 | $122 | $122 | — | — | — | $122 – $122 |
← Payers reporting HCPCS Q4309 · Snapshot 20261111T120946Z-9134e7f7