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 12.5X10CM 125SQ CM RESTRATA SOFT NONFRIABLE ABSORBABLE WOUND STERILE LATEX FREE WHITE
Charlotte, NC
See all hospitals reporting HCPCS A2007 →Price type
Carolinas Medical Center’s median price of $802 is 318% above the median hospital's median price ($192), higher than 85% of the 1,074 hospitals reporting HCPCS A2007. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 12 payers, 38 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 | Bcbs Nc local individual commercial percent of total billed charges · outpatientfrom % of charges | $359.40 | $365.89 | $10.42 – $736.77 |
| 2 | Amerihealth Caritas managed medicaid percent of total billed charges · outpatientfrom % of charges | $436.20 | $444.08 | $12.65 – $894.21 |
| 3 | WellCare managed medicaid percent of total billed charges · outpatientfrom % of charges | $444.40 | $452.42 | $12.89 – $911.02 |
| 4 | Bcbs Nc local group commercial percent of total billed charges · outpatientfrom % of charges | $472.20 | $480.73 | $13.69 – $968.01 |
| 5 | Aetna connected north carolina individual hmo percent of total billed charges · outpatientfrom % of charges | $530.00 | $539.57 | $15.37 – $1,087 |
| 6 | Ambetter cobranded commercial percent of total billed charges · outpatientfrom % of charges | $581.00 | $591.49 | $16.85 – $1,191 |
| 7 | Aetna connected north carolina individual hmo percent of total billed charges · inpatientfrom % of charges | $606.00 | $616.94 | $17.57 – $1,242 |
| 8 | Bcbs Nc hmo-ppo managed care percent of total billed charges · outpatientfrom % of charges | $621.20 | $632.41 | $18.01 – $1,273 |
| 9 | UnitedHealthcare managed medicaid percent of total billed charges · outpatientfrom % of charges | $652.60 | $664.38 | $18.93 – $1,338 |
| 10 | Aetna whole health hmo percent of total billed charges · inpatientfrom % of charges | $684.00 | $696.35 | $19.84 – $1,402 |
| 11 | Aetna whole health hmo percent of total billed charges · outpatientfrom % of charges | $722.00 | $735.03 | $20.94 – $1,480 |
| 12 | Ambetter individual commercial percent of total billed charges · outpatientfrom % of charges | $726.00 | $739.10 | $21.05 – $1,488 |
| 13 | UnitedHealthcare iex commercial percent of total billed charges · inpatientfrom % of charges | $804.00 | $818.51 | $23.32 – $1,648 |
| 14 | Aetna north carolina preferred plus commercial percent of total billed charges · outpatientfrom % of charges | $814.00 | $828.69 | $23.61 – $1,669 |
| 15 | Cigna commercial nb percent of total billed charges · inpatientfrom % of charges | $866.00 | $881.63 | $25.11 – $1,775 |
| 16 | Cigna commercial nb percent of total billed charges · outpatientfrom % of charges | $866.00 | $881.63 | $25.11 – $1,775 |
| 17 | Aetna north carolina preferred plus commercial percent of total billed charges · inpatientfrom % of charges | $898.00 | $914.21 | $26.04 – $1,841 |
| 18 | UnitedHealthcare hmo-ppo managed care percent of total billed charges · inpatientfrom % of charges | $906.00 | $922.35 | $26.27 – $1,857 |
| 19 | Cigna hmo-ppo managed care percent of total billed charges · inpatientfrom % of charges | $908.00 | $924.39 | $26.33 – $1,861 |
| 20 | Aetna broad network percent of total billed charges · outpatientfrom % of charges | $916.00 | $932.53 | $26.56 – $1,878 |
| 21 | Medcost ultra percent of total billed charges · inpatientfrom % of charges | $980.00 | $997.69 | $28.42 – $2,009 |
| 22 | Medcost ultra percent of total billed charges · outpatientfrom % of charges | $980.00 | $997.69 | $28.42 – $2,009 |
| 23 | Aetna broad network percent of total billed charges · inpatientfrom % of charges | $1,012 | $1,030 | $29.35 – $2,075 |
| 24 | Cigna hmo-ppo managed care percent of total billed charges · outpatientfrom % of charges | $1,036 | $1,055 | $30.04 – $2,124 |
| 25 | Medcost ppo percent of total billed charges · inpatientfrom % of charges | $1,162 | $1,183 | $33.70 – $2,382 |
Last updated: Dec 4, 2025
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