Microlyte matrix, priced 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

Miscellaneous M <46.50 and A <77.50

Payers reporting HCPCS A2005

Payer pricing summary

Low

Average

$607

Median

$181

High

$9.4k

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	UnitedHealthcare fee schedule · outpatient · +12 other terms	406	$255	$306	$215	70%	—	$48 – $1.6k
2	Aetna fee schedule · outpatient · +13 other terms	180	$136	$190	$177	93%	—	$69 – $2.2k
3	Blue Cross Blue Shield fee schedule · outpatient · +8 other terms	143	$121	$104	$176	169%	—	$0 – $1.0k
4	Humana fee schedule · outpatient · +8 other terms	91	$125	$201	$212	106%	—	$48 – $968
5	Cigna fee schedule · outpatient · +9 other terms	70	$129	$170	$106	62%	—	$119 – $644
6	Molina fee schedule · outpatient · +5 other terms	48	$194	$275	$408	149%	—	$51 – $3.4k
7	WellCare fee schedule · outpatient · +5 other terms	44	$136	$138	$14	10%	—	$119 – $171
8	Anthem facility · fee schedule · outpatient · +5 other terms	36	$118	$163	$183	112%	—	$3 – $1.2k
9	Ambetter fee schedule · outpatient · +2 other terms	33	$234	$246	$45	18%	—	$162 – $351
10	Devoted fee schedule · outpatient · +3 other terms	33	$125	$125	$7	6%	—	$116 – $139
11	Optum fee schedule · outpatient · +3 other terms	32	$125	$173	$91	53%	—	$113 – $459
12	Bcbs Tx fee schedule · outpatient	30	$2	$2	$1	31%	—	$1 – $6
13	Kaiser fee schedule · outpatient · +4 other terms	30	$207	$287	$210	73%	—	$125 – $1000
14	Caresource fee schedule · outpatient · +3 other terms	22	$100	$87	$62	71%	—	$48 – $199
15	Medicare fee schedule · outpatient · +1 other terms	18	$125	$125	—	—	—	$125 – $125
16	Medical Mutual facility · fee schedule · outpatient · +1 other terms	13	$118	$123	$13	10%	—	$118 – $167
17	Wellmark fee schedule · both · +1 other terms	13	$553	$553	—	—	—	$553 – $553
18	Tricare fee schedule · outpatient · +1 other terms	12	$113	$119	$10	8%	—	$113 – $148
19	Oscar facility · fee schedule · outpatient · +1 other terms	11	$175	$177	$3	2%	—	$175 – $182
20	Bcbs Nj fee schedule · outpatient	10	$550	$550	—	—	—	$550 – $550
21	Medica fee schedule · outpatient · +4 other terms	10	$541	$546	$136	25%	—	$328 – $699
22	Regence fee schedule · outpatient · +2 other terms	10	$146	$146	$4	3%	—	$140 – $156
23	Aetna Better Health fee schedule · inpatient · +2 other terms	7	$123	$123	—	—	—	$123 – $123
24	Excellus fee schedule · outpatient · +2 other terms	6	$236	$230	$60	26%	—	$127 – $351
25	Highmark fee schedule · outpatient · +3 other terms	6	$176	$708	$979	138%	—	$127 – $3.4k

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