Large sterile hydrogel wound dressing

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 sq in w/b

Payers reporting HCPCS A6247

Payer pricing summary

Low

Average

$40

Median

$34

High

$115

Payer rate distribution

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#
1	Humana fee schedule · outpatient · +9 other terms	300	$34	$52	$54	105%	—	$16 – $261
2	UnitedHealthcare fee schedule · outpatient · +11 other terms	295	$34	$32	$5	17%	—	$14 – $39
3	Aetna fee schedule · outpatient · +9 other terms	271	$34	$36	$18	49%	—	$11 – $205
4	Blue Cross Blue Shield fee schedule · outpatient · +8 other terms	188	$35	$41	$19	45%	—	$0 – $142
5	WellCare fee schedule · outpatient · +4 other terms	184	$35	$36	$6	16%	—	$33 – $66
6	Devoted fee schedule · outpatient · +2 other terms	163	$34	$34	$1	2%	—	$33 – $36
7	Cigna Healthspring fee schedule · outpatient · +2 other terms	116	$35	$34	$1	3%	—	$34 – $37
8	Molina fee schedule · outpatient · +4 other terms	96	$46	$47	$18	39%	—	$28 – $89
9	Cigna fee schedule · outpatient · +8 other terms	77	$35	$37	$9	24%	—	$33 – $85
10	Anthem fee schedule · outpatient · +6 other terms	73	$33	$34	$3	8%	—	$33 – $55
11	Kaiser fee schedule · outpatient · +6 other terms	42	$33	$37	$11	29%	—	$33 – $83
12	Superior Healthplan fee schedule · outpatient	40	$36	$36	$0	0%	—	$33 – $36
13	Clover fee schedule · outpatient · +1 other terms	37	$34	$34	$1	3%	—	$33 – $36
14	Bcbs Tx fee schedule · outpatient	31	$31	$32	$9	29%	—	$23 – $116
15	Optum fee schedule · outpatient · +1 other terms	25	$34	$39	$16	42%	—	$33 – $85
16	Oscar fee schedule · outpatient · +2 other terms	25	$33	$34	$1	4%	—	$33 – $38
17	Caresource facility · case rate · outpatient · +4 other terms	20	$11	$23	$21	90%	—	$7 – $68
18	Medicare fee schedule · outpatient	18	$33	$33	$0	1%	—	$33 – $33
19	Amerihealth Caritas fee schedule · outpatient · +2 other terms	16	$41	$40	$1	2%	—	$39 – $41
20	Wellmark fee schedule · both · +1 other terms	13	$30	$30	$1	3%	—	$24 – $30
21	Aetna Better Health fee schedule · outpatient · +2 other terms	12	$16	$23	$9	37%	—	$16 – $33
22	Ambetter case rate · outpatient · +5 other terms	12	$48	$50	$2	4%	—	$48 – $53
23	Bcbs Mn fee schedule · outpatient · +4 other terms	12	$29	$19	$16	85%	—	$0 – $36
24	Bcbs Nj fee schedule · outpatient	12	$33	$72	$49	68%	—	$33 – $147
25	Highmark fee schedule · outpatient · +5 other terms	10	$35	$36	$13	36%	—	$16 – $80

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