Wound matrix 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

Phoenix wnd mtrx, per sq cm

Payers reporting HCPCS A2015

Payer pricing summary

Low

Average

$888

Median

$254

High

$7.4k

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	UnitedHealthcare fee schedule · outpatient · +13 other terms	409	$296	$1.2k	$1.5k	125%	—	$48 – $9.0k
2	Aetna fee schedule · outpatient · +11 other terms	183	$127	$331	$577	174%	—	$69 – $2.1k
3	Blue Cross Blue Shield fee schedule · outpatient · +10 other terms	133	$119	$65	$86	134%	—	$1 – $431
4	Humana fee schedule · outpatient · +10 other terms	89	$125	$252	$641	255%	—	$48 – $4.5k
5	Cigna fee schedule · outpatient · +10 other terms	73	$129	$344	$572	166%	—	$119 – $2.3k
6	Molina fee schedule · outpatient · +6 other terms	46	$192	$263	$416	159%	—	$51 – $3.4k
7	WellCare fee schedule · outpatient · +6 other terms	42	$136	$138	$12	9%	—	$119 – $171
8	Ambetter fee schedule · outpatient · +4 other terms	33	$234	$256	$43	17%	—	$162 – $351
9	Anthem facility · fee schedule · outpatient · +6 other terms	33	$118	$151	$92	61%	—	$48 – $349
10	Devoted fee schedule · outpatient · +4 other terms	33	$125	$125	$7	6%	—	$116 – $139
11	Optum fee schedule · outpatient · +2 other terms	32	$125	$173	$91	53%	—	$113 – $459
12	Bcbs Tx fee schedule · outpatient	30	$11	$11	$3	31%	—	$8 – $40
13	Kaiser fee schedule · outpatient · +4 other terms	30	$207	$287	$210	73%	—	$125 – $1000
14	Caresource fee schedule · outpatient · +7 other terms	22	$100	$97	$67	69%	—	$48 – $199
15	Medicare fee schedule · outpatient	18	$125	$125	—	—	—	$125 – $125
16	Tricare fee schedule · outpatient · +2 other terms	15	$121	$119	$6	5%	—	$113 – $127
17	Medical Mutual facility · fee schedule · outpatient · +1 other terms	13	$118	$123	$13	10%	—	$118 – $167
18	Oscar facility · fee schedule · outpatient · +6 other terms	12	$175	$177	$3	1%	—	$175 – $182
19	Medica fee schedule · outpatient · +4 other terms	10	$227	$229	$57	25%	—	$138 – $293
20	Regence fee schedule · outpatient · +4 other terms	10	$146	$146	$4	3%	—	$140 – $156
21	Aetna Better Health fee schedule · inpatient · +3 other terms	7	$51	$51	—	—	—	$51 – $51
22	Amerihealth Caritas other · outpatient	6	$2.1k	$2.1k	—	—	—	$2.1k – $2.1k
23	Excellus fee schedule · outpatient · +2 other terms	6	$236	$230	$60	26%	—	$127 – $351
24	Highmark fee schedule · outpatient · +5 other terms	6	$176	$708	$979	138%	—	$127 – $3.4k
25	Bcbs Mn fee schedule · outpatient	5	$1	$1	$0	66%	—	$0 – $1

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