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 WOUND 10X10CM NOVOSORB BTM BTM-1010
Duluth, MN
See all hospitals reporting HCPCS Q4100 →Price type
Essentia Health Duluth’s median price of $20 is 99% below the median hospital's median price ($1.8k), higher than 5% of the 964 hospitals reporting HCPCS Q4100. 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, 26 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.
Filter by billing methodology
Filter by billing class
| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Blue Cross Blue Shield bcbs mn facility · fee schedule · outpatient | $1 | $1 | — | — | — | $1 – $1 |
| 2 | Medica medicaid facility · percent of total billed charges · outpatientfrom % of charges | $9 | $9 | — | — | — | $9 – $9 |
| 3 | Healthpartners medicaid facility · percent of total billed charges · outpatientfrom % of charges | $11 | $11 | — | — | — | $11 – $11 |
| 4 | Blue Cross Blue Shield medicaid facility · percent of total billed charges · outpatientfrom % of charges | $11 | $11 | — | — | — | $11 – $11 |
| 5 | Blue Cross Blue Shield shp facility · percent of total billed charges · outpatientfrom % of charges | $11 | $11 | — | — | — | $11 – $11 |
| 6 | Sanford Health Plan commercia-ndpers facility · percent of total billed charges · outpatientfrom % of charges | $12 | $12 | — | — | — | $12 – $12 |
| 7 | Blue Cross Blue Shield bcbs mn facility · percent of total billed charges · outpatientfrom % of charges | $12 | $12 | — | — | — | $12 – $12 |
| 8 | Sanford Health Plan commercial facility · percent of total billed charges · outpatientfrom % of charges | $12 | $12 | — | — | — | $12 – $12 |
| 9 | Medica commercial-fi facility · percent of total billed charges · outpatientfrom % of charges | $15 | $15 | — | — | — | $15 – $15 |
| 10 | Medica commercial-si facility · percent of total billed charges · outpatientfrom % of charges | $15 | $15 | — | — | — | $15 – $15 |
| 11 | Medica commercial facility · percent of total billed charges · outpatientfrom % of charges | $16 | $16 | $1 | 5% | — | $15 – $17 |
| 12 | Ucare commercial facility · percent of total billed charges · outpatientfrom % of charges | $18 | $18 | — | — | — | $18 – $18 |
| 13 | Cigna commercial facility · percent of total billed charges · outpatientfrom % of charges | $19 | $19 | — | — | — | $19 – $19 |
| 14 | Healthpartners commercial facility · percent of total billed charges · outpatientfrom % of charges | $19 | $19 | — | — | — | $19 – $19 |
| 15 | Healthpartners shp facility · percent of total billed charges · outpatientfrom % of charges | $19 | $19 | — | — | — | $19 – $19 |
| 16 | UnitedHealthcare commercial facility · percent of total billed charges · outpatientfrom % of charges | $20 | $20 | — | — | — | $20 – $20 |
| 17 | Blue Cross Blue Shield commercial facility · percent of total billed charges · outpatientfrom % of charges | $21 | $21 | — | — | — | $21 – $21 |
| 18 | Aetna commercial facility · percent of total billed charges · outpatientfrom % of charges | $23 | $23 | — | — | — | $23 – $23 |
| 19 | Blue Cross Blue Shield shp facility · percent of total billed charges · inpatientfrom % of charges | $12 | $3.0k | $4.2k | 141% | — | $11 – $8.9k |
| 20 | Sanford Health Plan commercia-ndpers facility · percent of total billed charges · inpatientfrom % of charges | $13 | $3.1k | $4.4k | 141% | — | $12 – $9.3k |
| 21 | Sanford Health Plan commercial facility · percent of total billed charges · inpatientfrom % of charges | $13 | $3.3k | $4.6k | 141% | — | $12 – $9.8k |
| 22 | Blue Cross Blue Shield medicaid facility · percent of total billed charges · inpatientfrom % of charges | $18 | $4.3k | $6.1k | 141% | — | $16 – $13.0k |
| 23 | Ucare commercial facility · percent of total billed charges · inpatientfrom % of charges | $19 | $4.8k | $6.7k | 141% | — | $18 – $14.2k |
| 24 | Blue Cross Blue Shield bcbs mn facility · percent of total billed charges · inpatientfrom % of charges | $20 | $4.8k | $6.8k | 141% | — | $18 – $14.4k |
| 25 | Blue Cross Blue Shield commercial facility · percent of total billed charges · inpatientfrom % of charges | $22 | $5.5k | $7.7k | 141% | — | $21 – $16.4k |
Last updated: Jan 1, 2026
See Amniotic membrane allograft, 9 x 20 cm pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.