Post-operative foam wound dressing, 12x4 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

FOAM DRG >16<=48 SQ IN W/BDR

Payers reporting HCPCS A6213

Payer pricing summary

Low

Average

$62

Median

$36

High

$320

Payer rate distribution

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#
1	Clover facility · percent of total billed charges · bothfrom % of charges	1	$11	$11	$14	127%	14	$0 – $45
2	Humana fee schedule · outpatient · +16 other terms	86	$37	$63	$49	77%	—	$1 – $141
3	UnitedHealthcare fee schedule · outpatient · +18 other terms	60	$13	$51	$48	94%	—	$1 – $122
4	Blue Cross Blue Shield facility · fee schedule · outpatient · +17 other terms	37	$27	$33	$25	76%	—	$0 – $116
5	Aetna fee schedule · outpatient · +18 other terms	34	$15	$22	$19	86%	—	$1 – $103
6	Medica fee schedule · outpatient · +13 other terms	30	$29	$34	$22	63%	—	$2 – $85
7	Healthcare Highways facility · percent of total billed charges · bothfrom % of charges · +1 other terms	20	$19	$37	$65	176%	—	$1 – $586
8	MultiPlan fee schedule · inpatient · +14 other terms	20	$53	$51	$36	70%	—	$6 – $182
9	Cigna fee schedule · both · +13 other terms	17	$33	$28	$9	33%	—	$0 – $33
10	Anthem facility · case rate · outpatient · +14 other terms	15	$15	$17	$4	23%	—	$10 – $26
11	Caresource fee schedule · outpatient · +9 other terms	15	$122	$115	$27	23%	—	$1 – $122
12	Molina facility · case rate · outpatient · +11 other terms	15	$15	$17	$4	23%	—	$11 – $26
13	Medcost percent of total billed charges · bothfrom % of charges · +4 other terms	13	$119	$119	$10	8%	—	$102 – $131
14	Wellmark fee schedule · both · +5 other terms	13	$7	$7	$4	48%	—	$7 – $29
15	Bcbs Mn fee schedule · outpatient · +7 other terms	12	$52	$33	$29	86%	—	$0 – $65
16	Highmark fee schedule · outpatient · +5 other terms	11	$11	$11	$1	5%	—	$9 – $11
17	Optum facility · case rate · outpatient · +3 other terms	11	$14	$16	$4	22%	—	$13 – $24
18	Phcs fee schedule · inpatient · +8 other terms	10	$44	$51	$26	51%	—	$15 – $87
19	Ucare fee schedule · both · +4 other terms	9	$17	$17	$1	5%	—	$16 – $18
20	Aetna Better Health fee schedule · outpatient · +5 other terms	8	$7	$8	$2	23%	—	$7 – $11
21	Oscar percent of total billed charges · outpatientfrom % of charges · +3 other terms	7	$11	$26	$37	145%	—	$9 – $117
22	Bcbs Id fee schedule · outpatient · +4 other terms	4	$31	$31	—	—	—	$31 – $31
23	Healthpartners facility · other · outpatient · +10 other terms	4	$6	$6	—	—	—	$6 – $6
24	Sanford Health Plan fee schedule · inpatient · +3 other terms	4	$16	$14	$6	42%	—	$6 – $20
25	Amerihealth Caritas other · outpatient · +5 other terms	3	$6	$6	$1	11%	—	$5 – $6

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