Symphony product charged per square centimeter, added to main procedure

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

Symphony, per square centimeter (add-on, list separately in addition to primary procedure)

Payers reporting HCPCS A2009

Payer pricing summary

Low

Average

$188

Median

$131

High

$741

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	UnitedHealthcare fee schedule · outpatient · +13 other terms	388	$210	$210	$101	48%	—	$48 – $782
2	Cigna fee schedule · outpatient · +11 other terms	179	$150	$285	$209	73%	—	$85 – $796
3	Aetna fee schedule · outpatient · +13 other terms	150	$127	$146	$44	30%	—	$69 – $444
4	Blue Cross Blue Shield fee schedule · outpatient · +10 other terms	132	$119	$76	$70	93%	—	$0 – $431
5	Humana fee schedule · outpatient · +8 other terms	75	$125	$128	$17	13%	—	$48 – $171
6	Molina fee schedule · outpatient · +7 other terms	48	$192	$261	$408	156%	—	$51 – $3.4k
7	WellCare fee schedule · outpatient · +7 other terms	44	$136	$138	$14	10%	—	$119 – $171
8	Anthem facility · fee schedule · outpatient · +8 other terms	36	$118	$150	$123	82%	—	$48 – $1.2k
9	Devoted fee schedule · outpatient · +5 other terms	33	$125	$125	$7	6%	—	$116 – $139
10	Kaiser fee schedule · outpatient · +3 other terms	32	$207	$287	$206	72%	—	$125 – $1000
11	Optum fee schedule · outpatient · +1 other terms	32	$125	$173	$91	53%	—	$113 – $459
12	Ambetter fee schedule · outpatient · +4 other terms	30	$240	$255	$38	15%	—	$193 – $351
13	Bcbs Tx fee schedule · outpatient	30	$32	$33	$10	31%	—	$24 – $121
14	Caresource facility · fee schedule · outpatient · +4 other terms	24	$212	$208	$29	14%	—	$121 – $248
15	Oscar facility · fee schedule · outpatient · +2 other terms	19	$182	$196	$25	13%	—	$175 – $234
16	Medicare fee schedule · outpatient · +1 other terms	18	$125	$125	—	—	—	$125 – $125
17	Highmark fee schedule · outpatient · +6 other terms	16	$102	$155	$336	216%	—	$93 – $3.4k
18	Medical Mutual facility · fee schedule · outpatient · +4 other terms	13	$118	$119	$3	3%	—	$118 – $127
19	Bcbs Nj fee schedule · outpatient	12	$91	$91	—	—	—	$91 – $91
20	Tricare fee schedule · outpatient · +1 other terms	11	$113	$116	$5	4%	—	$113 – $127
21	Regence fee schedule · outpatient · +4 other terms	10	$146	$146	$4	3%	—	$140 – $156
22	Medcost percent of total billed charges · bothfrom % of charges · +2 other terms	9	$243	$241	$85	35%	—	$144 – $433
23	Medica fee schedule · both · +3 other terms	9	$101	$100	$1	1%	—	$100 – $102
24	Excellus fee schedule · outpatient · +2 other terms	6	$236	$230	$60	26%	—	$127 – $351
25	Aetna Better Health facility · fee schedule · outpatient	5	$68	$68	$1	1%	—	$68 – $70

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