Innovamatrix dressing, per square centimeter

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

INNOVAMATRTIX AC 2X2CM 4 UNTS APPLIED

Payers reporting HCPCS A2001

Payer pricing summary

Low

Average

$770

Median

$603

High

$5.0k

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	UnitedHealthcare fee schedule · outpatient · +14 other terms	419	$296	$912	$1.1k	121%	—	$48 – $6.9k
2	Aetna fee schedule · outpatient · +15 other terms	216	$146	$704	$1.4k	201%	—	$69 – $11.9k
3	Cigna fee schedule · outpatient · +11 other terms	200	$1.6k	$3.1k	$3.2k	103%	—	$119 – $10.9k
4	Blue Cross Blue Shield fee schedule · outpatient · +12 other terms	162	$249	$394	$459	116%	—	$1 – $3.9k
5	Humana fee schedule · outpatient · +13 other terms	97	$127	$443	$904	204%	—	$48 – $4.2k
6	Molina fee schedule · outpatient · +9 other terms	53	$196	$321	$442	138%	—	$51 – $3.4k
7	WellCare fee schedule · outpatient · +6 other terms	47	$136	$138	$14	10%	—	$115 – $171
8	Kaiser fee schedule · outpatient · +5 other terms	39	$207	$312	$377	121%	—	$125 – $2.7k
9	Anthem facility · fee schedule · outpatient · +11 other terms	35	$118	$250	$435	174%	—	$48 – $3.1k
10	Ambetter fee schedule · outpatient · +3 other terms	33	$234	$246	$45	18%	—	$162 – $351
11	Devoted fee schedule · outpatient · +3 other terms	33	$125	$125	$7	6%	—	$116 – $139
12	Optum fee schedule · outpatient · +4 other terms	32	$125	$173	$91	53%	—	$113 – $459
13	Bcbs Tx fee schedule · outpatient	30	$239	$247	$77	31%	—	$182 – $901
14	Caresource fee schedule · outpatient · +3 other terms	25	$100	$104	$69	66%	—	$48 – $213
15	Oscar facility · fee schedule · outpatient · +1 other terms	19	$182	$196	$25	13%	—	$175 – $234
16	Medicare fee schedule · outpatient · +3 other terms	18	$125	$125	—	—	—	$125 – $125
17	Phcs percent of total billed charges · bothfrom % of charges · +2 other terms	18	$622	$5.5k	$5.6k	102%	—	$322 – $11.7k
18	Highmark fee schedule · outpatient · +6 other terms	17	$1.4k	$1.3k	$416	32%	—	$120 – $3.4k
19	Medica fee schedule · both · +5 other terms	15	$1.9k	$1.7k	$619	36%	—	$130 – $2.2k
20	Medical Mutual facility · fee schedule · outpatient · +2 other terms	14	$118	$150	$96	64%	—	$64 – $468
21	Wellmark fee schedule · both · +1 other terms	13	$1k	$1k	—	—	—	$1k – $1k
22	Bcbs Nj fee schedule · outpatient	12	$1.0k	$1.1k	$105	10%	—	$996 – $1.2k
23	Tricare fee schedule · outpatient · +1 other terms	12	$113	$119	$10	8%	—	$113 – $148
24	Beechstreet percent of total billed charges · bothfrom % of charges	11	$614	$609	$96	16%	—	$322 – $714
25	Regence fee schedule · outpatient · +2 other terms	10	$146	$146	$4	3%	—	$140 – $156

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