Skin substitute wound 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

Innovabrn/innovamatx xl sqcm

Payers reporting HCPCS A2022

Payer pricing summary

Low

$91

Average

$573

Median

$223

High

$3.1k

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	UnitedHealthcare fee schedule · outpatient · +9 other terms	402	$296	$1.1k	$1.3k	124%	—	$48 – $8.1k
2	Cigna fee schedule · outpatient · +7 other terms	219	$2.0k	$3.5k	$3.4k	96%	—	$119 – $12.4k
3	Aetna fee schedule · outpatient · +9 other terms	202	$146	$865	$1.7k	197%	—	$69 – $13.5k
4	Blue Cross Blue Shield fee schedule · outpatient · +6 other terms	147	$269	$441	$615	139%	—	$1 – $5.1k
5	Humana fee schedule · outpatient · +6 other terms	86	$125	$353	$774	219%	—	$48 – $4.8k
6	Molina fee schedule · outpatient · +6 other terms	53	$196	$341	$479	140%	—	$51 – $3.4k
7	WellCare fee schedule · outpatient · +4 other terms	47	$136	$139	$14	10%	—	$115 – $171
8	Ambetter fee schedule · outpatient · +2 other terms	33	$234	$246	$45	18%	—	$162 – $351
9	Anthem facility · fee schedule · outpatient · +4 other terms	33	$118	$151	$92	61%	—	$48 – $349
10	Devoted fee schedule · outpatient · +3 other terms	33	$125	$125	$7	6%	—	$116 – $139
11	Kaiser fee schedule · outpatient · +3 other terms	32	$207	$360	$483	134%	—	$125 – $3.1k
12	Optum fee schedule · outpatient · +1 other terms	32	$125	$173	$91	53%	—	$113 – $459
13	Bcbs Tx fee schedule · outpatient	30	$239	$247	$77	31%	—	$182 – $901
14	Caresource fee schedule · outpatient · +2 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	$1.6k	$1.5k	$385	25%	—	$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	$1.4k	$18	1%	—	$1.3k – $1.4k
20	Bcbs Nj fee schedule · outpatient	12	$1.3k	$1.3k	$52	4%	—	$1.3k – $1.4k
21	Tricare fee schedule · outpatient · +1 other terms	11	$113	$118	$10	8%	—	$113 – $148
22	Medica fee schedule · outpatient · +4 other terms	10	$2.1k	$2.1k	$526	25%	—	$1.3k – $2.7k
23	Regence fee schedule · outpatient · +2 other terms	10	$146	$146	$4	3%	—	$140 – $156
24	Bcbs Mn fee schedule · both · +2 other terms	8	$1.1k	$1.1k	$10	1%	—	$1.1k – $1.1k
25	Clover facility · fee schedule · outpatient · +1 other terms	8	$123	$123	$6	5%	—	$117 – $134

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