Miro3D collagen membrane, per cubic 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 Miro3d per Cubic Cm

Payers reporting HCPCS A2025

Payer pricing summary

Low

$69

Average

$390

Median

$193

High

$3.1k

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	Medicare fee schedule · outpatient · +3 other terms	19	$125	$224	$464	208%	1–10	$125 – $2.4k
2	UnitedHealthcare fee schedule · outpatient · +17 other terms	391	$264	$324	$240	74%	—	$48 – $1.9k
3	Cigna fee schedule · outpatient · +14 other terms	212	$319	$576	$470	82%	—	$119 – $1.8k
4	Aetna fee schedule · outpatient · +19 other terms	155	$149	$241	$262	109%	—	$69 – $2.2k
5	Blue Cross Blue Shield fee schedule · outpatient · +13 other terms	115	$201	$219	$113	52%	—	$1 – $977
6	Humana fee schedule · outpatient · +16 other terms	75	$125	$156	$127	81%	—	$48 – $931
7	Anthem facility · fee schedule · outpatient · +7 other terms	37	$118	$258	$194	75%	—	$48 – $688
8	Molina facility · fee schedule · outpatient · +11 other terms	35	$118	$131	$51	39%	—	$65 – $319
9	WellCare fee schedule · outpatient · +11 other terms	34	$136	$137	$14	10%	—	$119 – $171
10	Kaiser fee schedule · outpatient · +3 other terms	31	$207	$290	$208	72%	—	$125 – $1000
11	Bcbs Tx fee schedule · outpatient	30	$179	$184	$58	31%	—	$136 – $673
12	Devoted facility · fee schedule · outpatient · +7 other terms	24	$118	$125	$10	8%	—	$118 – $143
13	Ambetter fee schedule · outpatient · +7 other terms	23	$251	$253	$52	21%	—	$162 – $351
14	Optum fee schedule · outpatient · +5 other terms	22	$125	$151	$98	65%	—	$113 – $459
15	Caresource fee schedule · outpatient · +4 other terms	17	$100	$134	$347	258%	—	$48 – $2.4k
16	Medical Mutual facility · fee schedule · outpatient · +1 other terms	14	$118	$150	$96	64%	—	$64 – $468
17	Highmark fee schedule · outpatient · +7 other terms	13	$234	$278	$325	117%	—	$120 – $3.4k
18	Wellmark fee schedule · both · +2 other terms	13	$250	$249	$6	3%	—	$210 – $250
19	Bcbs Nj fee schedule · outpatient	12	$208	$208	—	—	—	$208 – $208
20	Medcost percent of total billed charges · bothfrom % of charges · +4 other terms	12	$98	$98	$6	6%	—	$93 – $104
21	Medica facility · other · outpatient · +9 other terms	11	$125	$125	$1	1%	—	$125 – $127
22	Tricare fee schedule · outpatient · +4 other terms	11	$113	$118	$10	8%	—	$113 – $148
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	$214	$214	$2	1%	—	$213 – $216
25	Aetna Better Health fee schedule · inpatient · +3 other terms	7	$206	$206	—	—	—	$206 – $206

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