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 TISSUE 8X4CM GRAFTJACKET NOW THK1-2MM STD ACELLULAR
Monroe, GA
See all hospitals reporting HCPCS Q4107 →Price type
Piedmont Walton’s median price of $7.6k is 3397% above the median hospital's median price ($216), higher than 96% of the 1,581 hospitals reporting HCPCS Q4107. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 9 payers, 12 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 | UnitedHealthcare united healthcare fee schedule · both | $248 | $248 | — | — | — | $248 – $248 |
| 2 | UnitedHealthcare united healthcare exchange fee schedule · both | $248 | $248 | — | — | — | $248 – $248 |
| 3 | Cigna cigna connect percent of total billed charges · bothfrom % of charges | $6.1k | $5.3k | $2.5k | 48% | — | $174 – $7.6k |
| 4 | Blue Cross Blue Shield blue cross hmo percent of total billed charges · bothfrom % of charges | $6.3k | $5.4k | $2.6k | 48% | — | $179 – $7.9k |
| 5 | Blue Cross Blue Shield blue cross ppo percent of total billed charges · bothfrom % of charges | $6.7k | $5.7k | $2.8k | 48% | — | $188 – $8.3k |
| 6 | Cigna cigna percent of total billed charges · bothfrom % of charges | $8.6k | $7.4k | $3.6k | 48% | — | $243 – $10.7k |
| 7 | First Health first health percent of total billed charges · bothfrom % of charges | $10.0k | $8.6k | $4.2k | 48% | — | $284 – $12.4k |
| 8 | MultiPlan multiplan percent of total billed charges · bothfrom % of charges | $11.4k | $9.8k | $4.8k | 48% | — | $324 – $14.2k |
| 9 | Phcs phcs percent of total billed charges · bothfrom % of charges | $11.4k | $9.8k | $4.8k | 48% | — | $324 – $14.2k |
| 10 | Aetna aetna hmo/ppo percent of total billed charges · bothfrom % of charges | $11.0k | $10.4k | $2.1k | 20% | — | $6.9k – $12.6k |
| 11 | Kaiser kaiser percent of total billed charges · bothfrom % of charges | $12.1k | $10.4k | $5.0k | 48% | — | $344 – $15.1k |
| 12 | Beechstreet beechstreet percent of total billed charges · bothfrom % of charges | $12.9k | $11.0k | $5.3k | 48% | — | $365 – $16.0k |
Last updated: Jul 1, 2026
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