Foam dressing, non-adhesive, 6 by 6 inches

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

HB-Mepilex Ag Dressing, No Border 4"X8" per Each

Payers reporting HCPCS A6210

Payer pricing summary

Low

Average

$37

Median

$35

High

$121

Payer rate distribution

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#
1	Humana fee schedule · outpatient · +19 other terms	302	$28	$43	$45	105%	—	$1 – $218
2	UnitedHealthcare fee schedule · outpatient · +21 other terms	298	$29	$27	$4	16%	—	$1 – $39
3	Aetna fee schedule · outpatient · +21 other terms	272	$29	$31	$14	47%	—	$13 – $172
4	Blue Cross Blue Shield fee schedule · outpatient · +17 other terms	206	$29	$35	$15	44%	—	$0 – $119
5	WellCare fee schedule · outpatient · +9 other terms	185	$29	$30	$5	16%	—	$28 – $55
6	Devoted fee schedule · outpatient · +6 other terms	162	$28	$29	$1	2%	—	$27 – $30
7	Cigna Healthspring fee schedule · outpatient · +3 other terms	116	$29	$29	$1	3%	—	$28 – $31
8	Molina fee schedule · outpatient · +13 other terms	97	$37	$39	$15	39%	—	$1 – $74
9	Cigna fee schedule · outpatient · +16 other terms	81	$29	$31	$9	29%	—	$7 – $71
10	Anthem fee schedule · outpatient · +17 other terms	75	$28	$29	$4	15%	—	$27 – $63
11	Superior Healthplan fee schedule · outpatient · +1 other terms	40	$30	$30	$0	0%	—	$28 – $30
12	Kaiser fee schedule · outpatient · +9 other terms	39	$28	$28	$1	2%	—	$27 – $29
13	Clover fee schedule · outpatient · +1 other terms	37	$28	$29	$1	3%	—	$28 – $30
14	Bcbs Tx fee schedule · outpatient · +2 other terms	31	$26	$27	$8	29%	—	$20 – $97
15	Optum fee schedule · outpatient · +6 other terms	25	$28	$33	$14	42%	—	$27 – $71
16	Oscar fee schedule · outpatient · +6 other terms	24	$28	$29	$1	3%	—	$28 – $30
17	Caresource fee schedule · outpatient · +8 other terms	21	$28	$26	$6	24%	—	$1 – $28
18	Ambetter facility · fee schedule · outpatient · +12 other terms	19	$51	$49	$4	8%	—	$41 – $51
19	Medicare fee schedule · outpatient · +4 other terms	18	$27	$27	$0	1%	—	$27 – $28
20	Amerihealth Caritas fee schedule · outpatient · +6 other terms	16	$34	$34	$1	2%	—	$32 – $34
21	Highmark facility · fee schedule · outpatient · +8 other terms	15	$53	$81	$53	66%	—	$28 – $275
22	Aetna Better Health fee schedule · outpatient · +6 other terms	14	$16	$22	$7	32%	—	$13 – $28
23	Wellmark fee schedule · both · +3 other terms	13	$25	$25	$1	3%	—	$20 – $25
24	Bcbs Mn fee schedule · outpatient · +8 other terms	12	$24	$16	$13	84%	—	$0 – $30
25	Bcbs Nj fee schedule · outpatient	12	$28	$60	$41	68%	—	$28 – $123

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