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
MATRIX FLOWABLE WND 3MG/PER MG
Arlington, TX
See all hospitals reporting HCPCS Q4114 →Price type
AMH Cath Labs LLC’s median price of $4.7k is 54% above the median hospital's median price ($3.1k), higher than 75% of the 1,270 hospitals reporting HCPCS Q4114. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 8 payers, 25 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Blue Cross Blue Shield managed medicaid percent of total billed charges · outpatientfrom % of charges | $760 | $760 | — | — | — | $760 – $760 |
| 2 | UnitedHealthcare managed medicaid percent of total billed charges · outpatientfrom % of charges | $760 | $760 | — | — | — | $760 – $760 |
| 3 | WellCare managed medicaid percent of total billed charges · outpatientfrom % of charges | $799 | $799 | — | — | — | $799 – $799 |
| 4 | Molina managed medicaid percent of total billed charges · outpatientfrom % of charges | $821 | $821 | — | — | — | $821 – $821 |
| 5 | Aetna managed medicaid percent of total billed charges · outpatientfrom % of charges | $836 | $836 | — | — | — | $836 – $836 |
| 6 | Aetna whole health percent of total billed charges · inpatientfrom % of charges | $3.0k | $3.0k | — | — | — | $3.0k – $3.0k |
| 7 | Blue Cross Blue Shield hmo fee schedule · outpatient | $3.4k | $3.4k | — | — | — | $3.4k – $3.4k |
| 8 | Blue Cross Blue Shield exchange fee schedule · outpatient | $3.4k | $3.4k | — | — | — | $3.4k – $3.4k |
| 9 | Aetna whole health percent of total billed charges · outpatientfrom % of charges | $3.5k | $3.5k | — | — | — | $3.5k – $3.5k |
| 10 | Blue Cross Blue Shield ppo fee schedule · outpatient | $3.7k | $3.7k | — | — | — | $3.7k – $3.7k |
| 11 | Aetna commercial percent of total billed charges · inpatientfrom % of charges | $3.9k | $3.9k | — | — | — | $3.9k – $3.9k |
| 12 | UnitedHealthcare all payer percent of total billed charges · outpatientfrom % of charges | $4.4k | $4.4k | — | — | — | $4.4k – $4.4k |
| 13 | Aetna commercial percent of total billed charges · outpatientfrom % of charges | $4.7k | $4.7k | — | — | — | $4.7k – $4.7k |
| 14 | UnitedHealthcare ppo percent of total billed charges · outpatientfrom % of charges | $4.7k | $4.7k | — | — | — | $4.7k – $4.7k |
| 15 | Cigna oap/hmo percent of total billed charges · outpatientfrom % of charges | $4.7k | $4.7k | — | — | — | $4.7k – $4.7k |
| 16 | Phcs ppo percent of total billed charges · outpatientfrom % of charges | $5.9k | $5.9k | — | — | — | $5.9k – $5.9k |
| 17 | Cigna ppo percent of total billed charges · outpatientfrom % of charges | $6.0k | $6.0k | — | — | — | $6.0k – $6.0k |
| 18 | Aetna asa percent of total billed charges · outpatientfrom % of charges | $6.0k | $6.0k | — | — | — | $6.0k – $6.0k |
| 19 | Aetna coventry percent of total billed charges · outpatientfrom % of charges | $6.0k | $6.0k | — | — | — | $6.0k – $6.0k |
| 20 | Phcs ppo percent of total billed charges · inpatientfrom % of charges | $6.4k | $6.4k | — | — | — | $6.4k – $6.4k |
| 21 | MultiPlan commercial percent of total billed charges · inpatientfrom % of charges | $7.4k | $7.4k | — | — | — | $7.4k – $7.4k |
| 22 | MultiPlan commercial percent of total billed charges · outpatientfrom % of charges | $7.4k | $7.4k | — | — | — | $7.4k – $7.4k |
| 23 | Cigna indemnity percent of total billed charges · inpatientfrom % of charges | $8.0k | $8.0k | — | — | — | $8.0k – $8.0k |
| 24 | Cigna indemnity percent of total billed charges · outpatientfrom % of charges | $8.0k | $8.0k | — | — | — | $8.0k – $8.0k |
| 25 | Blue Cross Blue Shield traditional fee schedule · outpatient | $15.3k | $15.3k | — | — | — | $15.3k – $15.3k |
Last updated: Apr 21, 2026
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