Innovamatrix FS add-on, 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

HC (SUP SHELL A2013) INNOVAMATRIX FS, PER SQ CM

Payers reporting HCPCS A2013

Payer pricing summary

Low

$11

Average

$560

Median

$304

High

$2.9k

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	UnitedHealthcare fee schedule · outpatient · +10 other terms	417	$296	$1.0k	$1.2k	123%	—	$48 – $7.7k
2	Cigna fee schedule · outpatient · +7 other terms	225	$1.9k	$3.4k	$3.2k	96%	—	$119 – $11.8k
3	Aetna fee schedule · outpatient · +8 other terms	212	$146	$729	$1.6k	215%	—	$69 – $13.3k
4	Blue Cross Blue Shield fee schedule · outpatient · +6 other terms	159	$121	$246	$558	227%	—	$1 – $4.2k
5	Humana fee schedule · outpatient · +7 other terms	96	$127	$468	$1.0k	214%	—	$48 – $4.7k
6	Molina fee schedule · outpatient · +7 other terms	53	$196	$335	$467	140%	—	$51 – $3.4k
7	WellCare fee schedule · outpatient · +4 other terms	47	$136	$138	$14	10%	—	$115 – $171
8	Kaiser fee schedule · outpatient · +3 other terms	39	$207	$316	$402	127%	—	$125 – $2.9k
9	Anthem facility · fee schedule · outpatient · +5 other terms	35	$118	$250	$435	174%	—	$48 – $3.1k
10	Ambetter fee schedule · outpatient · +2 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 · +2 other terms	32	$125	$173	$91	53%	—	$113 – $459
13	Bcbs Tx fee schedule · outpatient	30	$11	$11	$3	31%	—	$8 – $40
14	Caresource fee schedule · outpatient · +3 other terms	24	$100	$94	$65	69%	—	$48 – $213
15	Oscar facility · fee schedule · outpatient · +1 other terms	19	$182	$196	$25	13%	—	$175 – $234
16	Medicare fee schedule · outpatient	18	$125	$125	—	—	—	$125 – $125
17	Highmark fee schedule · outpatient · +4 other terms	16	$1.5k	$1.4k	$369	26%	—	$127 – $3.4k
18	Medical Mutual facility · fee schedule · outpatient · +2 other terms	14	$118	$150	$96	64%	—	$64 – $468
19	Wellmark fee schedule · both · +1 other terms	13	$1.4k	$1.3k	$10	1%	—	$1.3k – $1.4k
20	Bcbs Nj fee schedule · outpatient	12	$1.3k	$1.3k	$31	2%	—	$1.3k – $1.3k
21	Tricare fee schedule · outpatient · +1 other terms	12	$113	$119	$10	8%	—	$113 – $148
22	Medica fee schedule · outpatient · +4 other terms	10	$2.3k	$2.4k	$589	25%	—	$1.4k – $3.0k
23	Regence fee schedule · outpatient · +4 other terms	10	$146	$146	$4	3%	—	$140 – $156
24	Clover facility · fee schedule · outpatient · +1 other terms	8	$123	$123	$6	5%	—	$117 – $134
25	Aetna Better Health fee schedule · inpatient · +2 other terms	7	$506	$506	—	—	—	$506 – $506

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