Biodfence dermal wound matrix, per square centimeter

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

MEMBRANE PLACENTA TISS BIODFENCE G3 4X4CM-16SQCM-Q4116-COST PER SQ CM

Payers reporting HCPCS Q4140

Payer pricing summary

Low

$91

Average

$1.4k

Median

$670

High

$11.7k

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	UnitedHealthcare fee schedule · outpatient · +17 other terms	420	$210	$254	$139	55%	—	$1 – $1.1k
2	Cigna fee schedule · outpatient · +18 other terms	273	$312	$561	$391	70%	—	$119 – $1.9k
3	Aetna fee schedule · outpatient · +19 other terms	249	$148	$238	$205	86%	—	$69 – $2.1k
4	Humana fee schedule · outpatient · +16 other terms	180	$164	$149	$40	27%	—	$1 – $357
5	Blue Cross Blue Shield fee schedule · outpatient · +21 other terms	138	$169	$197	$117	60%	—	$1 – $878
6	Molina fee schedule · outpatient · +12 other terms	84	$201	$270	$341	126%	—	$1 – $3.4k
7	Caresource fee schedule · outpatient · +8 other terms	63	$191	$191	$166	87%	—	$1 – $524
8	Anthem facility · fee schedule · outpatient · +13 other terms	54	$161	$201	$151	75%	—	$48 – $1.2k
9	WellCare fee schedule · outpatient · +8 other terms	50	$138	$140	$16	11%	—	$115 – $171
10	Kaiser fee schedule · outpatient · +10 other terms	41	$207	$270	$182	67%	—	$125 – $1000
11	Ambetter fee schedule · outpatient · +8 other terms	39	$234	$254	$54	21%	—	$155 – $351
12	Devoted fee schedule · outpatient · +5 other terms	34	$125	$125	$8	6%	—	$116 – $139
13	Optum fee schedule · outpatient · +8 other terms	32	$125	$173	$91	53%	—	$113 – $459
14	Phcs facility · percent of total billed charges · bothfrom % of charges · +2 other terms	27	$487	$496	$244	49%	—	$175 – $1.1k
15	Bcbs La fee schedule · outpatient · +2 other terms	25	$311	$308	$13	4%	—	$186 – $311
16	Aetna Better Health other · outpatient · +3 other terms	19	$1.4k	$1.8k	$2.0k	108%	—	$538 – $15.7k
17	Amerihealth Caritas other · outpatient · +2 other terms	19	$1.4k	$1.8k	$2.0k	108%	—	$538 – $15.7k
18	Healthpartners fee schedule · outpatient · +5 other terms	19	$205	$203	$13	6%	—	$131 – $210
19	Oscar facility · fee schedule · outpatient · +5 other terms	19	$190	$198	$21	11%	—	$175 – $234
20	Medical Mutual facility · fee schedule · outpatient · +4 other terms	18	$294	$337	$185	55%	—	$64 – $703
21	Medicare fee schedule · outpatient · +5 other terms	18	$125	$125	—	—	—	$125 – $125
22	Highmark fee schedule · outpatient · +6 other terms	17	$209	$258	$322	125%	—	$120 – $3.4k
23	Tricare fee schedule · outpatient · +5 other terms	17	$121	$121	$9	7%	—	$113 – $148
24	Medcost facility · percent of total billed charges · bothfrom % of charges · +3 other terms	15	$394	$737	$1.5k	203%	—	$210 – $7.8k
25	Medica fee schedule · both · +10 other terms	15	$593	$458	$301	66%	—	$130 – $798

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