Repriza skin substitute, 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

Repriza, 1cm

Payers reporting HCPCS Q4143

Payer pricing summary

Low

$23

Average

$120

Median

$120

High

$350

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +11 other terms	407	$154	$159	$108	68%	—	$1 – $613
2	Cigna fee schedule · outpatient · +9 other terms	279	$71	$112	$84	75%	—	$6 – $644
3	Aetna fee schedule · outpatient · +12 other terms	209	$127	$130	$66	51%	—	$28 – $515
4	Humana fee schedule · outpatient · +11 other terms	184	$75	$86	$49	57%	—	$1 – $170
5	Blue Cross Blue Shield fee schedule · outpatient · +7 other terms	132	$125	$129	$97	75%	—	$1 – $580
6	Molina fee schedule · outpatient · +10 other terms	62	$191	$232	$382	164%	—	$1 – $3.4k
7	Anthem facility · fee schedule · outpatient · +7 other terms	54	$130	$143	$148	104%	—	$34 – $1.2k
8	Caresource fee schedule · outpatient · +4 other terms	50	$51	$79	$58	74%	—	$1 – $213
9	WellCare fee schedule · outpatient · +7 other terms	49	$135	$125	$36	28%	—	$34 – $171
10	Ambetter fee schedule · outpatient · +5 other terms	42	$234	$216	$75	35%	—	$32 – $351
11	Kaiser fee schedule · outpatient · +4 other terms	42	$207	$265	$182	69%	—	$71 – $1000
12	Devoted fee schedule · outpatient · +3 other terms	34	$125	$125	$8	6%	—	$116 – $139
13	Optum fee schedule · outpatient · +3 other terms	32	$125	$173	$91	53%	—	$113 – $459
14	Healthpartners fee schedule · outpatient · +1 other terms	19	$41	$43	$15	34%	—	$40 – $131
15	Oscar facility · fee schedule · outpatient · +2 other terms	19	$182	$150	$73	49%	—	$42 – $234
16	Medical Mutual facility · fee schedule · outpatient · +3 other terms	18	$118	$114	$68	60%	—	$46 – $468
17	Medicare fee schedule · outpatient · +2 other terms	18	$125	$125	—	—	—	$125 – $125
18	Highmark fee schedule · outpatient · +4 other terms	16	$42	$100	$345	345%	—	$34 – $3.4k
19	Bcbs Mn fee schedule · outpatient · +3 other terms	12	$50	$36	$25	70%	—	$1 – $63
20	Aetna Better Health fee schedule · outpatient · +3 other terms	11	$30	$32	$3	10%	—	$30 – $37
21	Bcbs Nj fee schedule · outpatient	11	$34	$34	$1	2%	—	$34 – $35
22	Tricare fee schedule · outpatient · +1 other terms	11	$113	$118	$10	8%	—	$113 – $148
23	Medica fee schedule · outpatient · +4 other terms	10	$60	$61	$15	25%	—	$37 – $78
24	Regence fee schedule · outpatient · +4 other terms	10	$146	$146	$4	3%	—	$140 – $156
25	Clover fee schedule · outpatient · +2 other terms	9	$120	$95	$44	46%	—	$34 – $140

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