Permeaderm skin graft 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

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

Payers reporting HCPCS A2016

Payer pricing summary

Low

Average

$305

Median

$154

High

$4.1k

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	UnitedHealthcare fee schedule · outpatient · +16 other terms	255	$210	$325	$632	194%	—	$1 – $3.8k
2	Blue Cross Blue Shield fee schedule · outpatient · +12 other terms	93	$46	$56	$35	63%	—	$1 – $170
3	Aetna fee schedule · outpatient · +16 other terms	90	$126	$883	$1.6k	183%	—	$69 – $5.9k
4	Humana fee schedule · outpatient · +12 other terms	69	$125	$125	$20	16%	—	$1 – $171
5	Cigna fee schedule · outpatient · +12 other terms	58	$131	$310	$640	206%	—	$119 – $3.3k
6	WellCare fee schedule · outpatient · +9 other terms	41	$136	$138	$14	10%	—	$119 – $171
7	Anthem facility · fee schedule · outpatient · +8 other terms	34	$118	$162	$105	65%	—	$48 – $428
8	Molina facility · fee schedule · outpatient · +10 other terms	34	$118	$129	$50	39%	—	$65 – $319
9	Bcbs Tx fee schedule · outpatient	30	$32	$33	$10	31%	—	$24 – $121
10	Devoted fee schedule · outpatient · +3 other terms	23	$125	$122	$5	4%	—	$116 – $139
11	Kaiser fee schedule · outpatient · +5 other terms	23	$125	$634	$937	148%	—	$125 – $3.3k
12	Optum fee schedule · outpatient · +6 other terms	22	$125	$151	$98	65%	—	$113 – $459
13	Ambetter fee schedule · outpatient · +4 other terms	20	$272	$267	$41	15%	—	$218 – $351
14	Caresource facility · case rate · outpatient · +3 other terms	19	$968	$862	$456	53%	—	$49 – $1.7k
15	Medicare fee schedule · outpatient · +1 other terms	18	$125	$125	—	—	—	$125 – $125
16	Medical Mutual facility · fee schedule · outpatient · +1 other terms	12	$118	$123	$13	11%	—	$118 – $167
17	Oscar facility · fee schedule · outpatient · +4 other terms	10	$175	$177	$3	2%	—	$175 – $182
18	Regence fee schedule · outpatient · +4 other terms	10	$146	$146	$4	3%	—	$140 – $156
19	Tricare fee schedule · outpatient · +1 other terms	10	$113	$115	$4	3%	—	$113 – $121
20	MultiPlan other · both · +6 other terms	8	$134	$134	$0	0%	—	$134 – $134
21	Excellus fee schedule · outpatient · +2 other terms	6	$212	$124	$122	98%	—	$0 – $351
22	Highmark fee schedule · outpatient · +3 other terms	6	$176	$708	$979	138%	—	$127 – $3.4k
23	Aetna Better Health facility · fee schedule · outpatient · +2 other terms	5	$68	$68	$1	1%	—	$68 – $70
24	Bcbs Mn fee schedule · outpatient	5	$1	$1	$0	66%	—	$0 – $1
25	Clover fee schedule · outpatient	5	$120	$125	$9	7%	—	$120 – $140

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