Foam dressing for wound, 4x4 inch

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-Dressing Soft Silicone Mepilex Border Flex 3inx3in

Payers reporting HCPCS A6212

Payer pricing summary

Low

Average

$43

Median

$21

High

$467

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +20 other terms	338	$14	$25	$112	443%	—	$1 – $1.2k
2	Humana fee schedule · outpatient · +20 other terms	321	$14	$23	$40	176%	—	$1 – $890
3	Aetna fee schedule · outpatient · +21 other terms	285	$14	$40	$179	447%	—	$2 – $1.9k
4	Blue Cross Blue Shield fee schedule · outpatient · +16 other terms	209	$14	$15	$6	39%	—	$0 – $58
5	WellCare fee schedule · outpatient · +8 other terms	185	$14	$15	$2	16%	—	$14 – $27
6	Devoted fee schedule · outpatient · +6 other terms	162	$14	$14	$0	2%	—	$13 – $15
7	Cigna Healthspring fee schedule · outpatient · +3 other terms	116	$14	$14	$0	3%	—	$14 – $15
8	Molina fee schedule · outpatient · +12 other terms	98	$20	$31	$176	575%	—	$1 – $2.6k
9	Cigna fee schedule · outpatient · +16 other terms	85	$14	$33	$132	400%	—	$7 – $1.1k
10	Anthem fee schedule · outpatient · +15 other terms	78	$14	$7	$5	70%	—	$1 – $23
11	Kaiser fee schedule · outpatient · +11 other terms	42	$14	$41	$156	384%	—	$13 – $1.1k
12	Superior Healthplan fee schedule · outpatient · +1 other terms	42	$15	$28	$81	292%	—	$2 – $890
13	Clover fee schedule · outpatient · +2 other terms	37	$14	$14	$0	3%	—	$14 – $15
14	MultiPlan fee schedule · outpatient · +16 other terms	34	$18	$30	$34	115%	—	$4 – $133
15	Caresource fee schedule · outpatient · +7 other terms	32	$14	$70	$54	78%	—	$1 – $122
16	Bcbs Tx fee schedule · outpatient · +3 other terms	31	$13	$13	$4	29%	—	$10 – $47
17	Medica fee schedule · outpatient · +12 other terms	31	$22	$18	$8	45%	—	$2 – $35
18	Optum fee schedule · outpatient · +6 other terms	26	$14	$16	$7	42%	—	$13 – $35
19	Oscar fee schedule · outpatient · +7 other terms	24	$14	$14	$0	3%	—	$14 – $15
20	Highmark facility · fee schedule · outpatient · +7 other terms	18	$25	$41	$26	64%	—	$14 – $134
21	Medicare fee schedule · outpatient · +6 other terms	18	$13	$13	$0	1%	—	$13 – $14
22	Amerihealth Caritas fee schedule · outpatient · +7 other terms	16	$17	$16	$0	2%	—	$16 – $17
23	Aetna Better Health fee schedule · outpatient · +7 other terms	15	$9	$12	$4	34%	—	$7 – $30
24	Ambetter facility · fee schedule · outpatient · +9 other terms	13	$25	$20	$8	42%	—	$0 – $25
25	Wellmark fee schedule · both · +2 other terms	13	$12	$12	$0	3%	—	$10 – $12

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