Sterile hydrogel wound dressing, large pad without 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

Hydrogel drg >48 in w/o bdr

Payers reporting HCPCS A6244

Payer pricing summary

Low

$15

Average

$88

Median

$62

High

$541

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +13 other terms	301	$56	$57	$26	46%	—	$14 – $558
2	Humana fee schedule · outpatient · +12 other terms	299	$56	$85	$90	105%	—	$26 – $431
3	Aetna fee schedule · outpatient · +11 other terms	266	$56	$63	$40	64%	—	$25 – $566
4	WellCare fee schedule · outpatient · +5 other terms	185	$58	$60	$11	18%	—	$55 – $140
5	Blue Cross Blue Shield fee schedule · outpatient · +7 other terms	181	$57	$68	$31	45%	—	$0 – $234
6	Devoted fee schedule · outpatient · +2 other terms	163	$56	$56	$1	2%	—	$54 – $59
7	Cigna Healthspring fee schedule · outpatient · +2 other terms	116	$58	$57	$2	3%	—	$56 – $60
8	Molina fee schedule · outpatient · +4 other terms	96	$76	$77	$30	39%	—	$47 – $147
9	Cigna fee schedule · outpatient · +9 other terms	78	$57	$67	$51	76%	—	$54 – $549
10	Anthem fee schedule · outpatient · +8 other terms	74	$55	$63	$56	89%	—	$54 – $565
11	Superior Healthplan fee schedule · outpatient	40	$59	$59	$0	0%	—	$55 – $59
12	Kaiser fee schedule · outpatient · +4 other terms	39	$55	$55	$1	2%	—	$54 – $57
13	Clover fee schedule · outpatient · +1 other terms	37	$56	$57	$2	3%	—	$55 – $59
14	Bcbs Tx fee schedule · outpatient	31	$52	$53	$16	29%	—	$39 – $192
15	Caresource fee schedule · outpatient · +4 other terms	30	$56	$94	$33	35%	—	$56 – $122
16	Optum fee schedule · outpatient · +2 other terms	26	$56	$75	$56	75%	—	$54 – $327
17	Oscar fee schedule · outpatient · +2 other terms	24	$55	$57	$2	3%	—	$55 – $59
18	Medicare fee schedule · outpatient	18	$54	$54	$0	1%	—	$54 – $55
19	Amerihealth Caritas fee schedule · outpatient · +1 other terms	16	$67	$67	$1	2%	—	$64 – $67
20	Wellmark fee schedule · both · +1 other terms	13	$49	$49	$1	3%	—	$40 – $49
21	Aetna Better Health fee schedule · outpatient · +2 other terms	12	$26	$38	$14	37%	—	$26 – $55
22	Ambetter case rate · outpatient · +5 other terms	12	$80	$82	$4	4%	—	$80 – $88
23	Bcbs Mn fee schedule · outpatient · +4 other terms	12	$48	$31	$26	86%	—	$0 – $60
24	Bcbs Nj fee schedule · outpatient	12	$55	$118	$80	68%	—	$55 – $243
25	Highmark fee schedule · outpatient · +5 other terms	10	$57	$59	$21	36%	—	$26 – $132

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