Sterile foam wound pad, 16 sq. in. or less, no adhesive border

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 Drsg Hydrofera 2.5x2.5in

Payers reporting HCPCS A6209

Payer pricing summary

Low

Average

$79

Median

$22

High

$1.1k

Payer rate distribution

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#
1	Bcbs Al other · outpatient	1	$2	$2	—	—	2–20	$2 – $2
2	UnitedHealthcare fee schedule · outpatient · +20 other terms	332	$11	$18	$29	163%	—	$1 – $326
3	Humana fee schedule · outpatient · +18 other terms	314	$11	$16	$17	104%	—	$1 – $82
4	Aetna fee schedule · outpatient · +20 other terms	282	$11	$15	$24	161%	—	$5 – $326
5	Blue Cross Blue Shield fee schedule · outpatient · +16 other terms	216	$11	$14	$6	44%	—	$0 – $45
6	WellCare fee schedule · outpatient · +11 other terms	186	$11	$11	$2	16%	—	$10 – $21
7	Devoted fee schedule · outpatient · +6 other terms	162	$11	$11	$0	2%	—	$10 – $11
8	Cigna Healthspring fee schedule · outpatient · +3 other terms	116	$11	$11	$0	3%	—	$11 – $12
9	Molina fee schedule · outpatient · +13 other terms	98	$14	$15	$6	39%	—	$1 – $28
10	Cigna fee schedule · outpatient · +15 other terms	83	$11	$19	$40	209%	—	$7 – $318
11	Anthem fee schedule · outpatient · +16 other terms	76	$10	$11	$4	38%	—	$10 – $45
12	Kaiser fee schedule · outpatient · +10 other terms	41	$10	$12	$6	52%	—	$10 – $46
13	Superior Healthplan fee schedule · outpatient · +3 other terms	41	$11	$12	$4	34%	—	$9 – $57
14	Clover fee schedule · outpatient · +1 other terms	37	$11	$11	$0	3%	—	$10 – $11
15	Caresource fee schedule · outpatient · +8 other terms	32	$11	$87	$52	60%	—	$1 – $122
16	Bcbs Tx fee schedule · outpatient · +2 other terms	31	$10	$10	$3	29%	—	$7 – $36
17	MultiPlan fee schedule · outpatient · +15 other terms	29	$31	$42	$32	77%	—	$10 – $128
18	Medica fee schedule · outpatient · +10 other terms	27	$22	$24	$15	63%	—	$4 – $113
19	Optum fee schedule · outpatient · +7 other terms	26	$11	$12	$5	41%	—	$10 – $27
20	Oscar fee schedule · outpatient · +7 other terms	24	$10	$11	$0	3%	—	$10 – $11
21	Highmark facility · fee schedule · outpatient · +8 other terms	20	$20	$34	$22	65%	—	$11 – $103
22	Medicare fee schedule · outpatient · +6 other terms	18	$10	$10	$0	1%	—	$10 – $10
23	Ambetter facility · fee schedule · outpatient · +11 other terms	17	$15	$15	$7	45%	—	$0 – $19
24	Amerihealth Caritas fee schedule · outpatient · +5 other terms	16	$13	$13	$0	2%	—	$12 – $13
25	Aetna Better Health fee schedule · outpatient · +6 other terms	13	$5	$9	$3	30%	—	$5 – $11

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