Neox 100 skin substitute graft, 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-sonnet-5-5
Provider: anthropic
API: message_batches
Reasoning effort: model default
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Neox 100 1 square cm

Payers reporting HCPCS Q4156

Payer pricing summary

Low

$21

Average

$584

Median

$178

High

$4.3k

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +14 other terms	454	$182	$267	$572	214%	—	$48 – $8.1k
2	Cigna fee schedule · outpatient · +13 other terms	283	$132	$433	$1.4k	327%	—	$53 – $17.3k
3	Aetna fee schedule · outpatient · +16 other terms	255	$132	$398	$828	208%	—	$65 – $4.6k
4	Humana fee schedule · outpatient · +13 other terms	185	$116	$126	$116	92%	—	$48 – $1.1k
5	Blue Cross Blue Shield fee schedule · outpatient · +13 other terms	164	$133	$430	$1.3k	295%	—	$1 – $13.2k
6	Molina fee schedule · outpatient · +12 other terms	92	$191	$498	$888	178%	—	$51 – $4.1k
7	Caresource fee schedule · outpatient · +7 other terms	62	$111	$186	$194	104%	—	$48 – $524
8	Anthem facility · fee schedule · outpatient · +11 other terms	56	$161	$166	$148	89%	—	$48 – $1.2k
9	Kaiser fee schedule · outpatient · +11 other terms	51	$264	$1.5k	$2.5k	174%	—	$125 – $12.4k
10	WellCare fee schedule · outpatient · +9 other terms	49	$135	$129	$26	20%	—	$65 – $171
11	Ambetter fee schedule · outpatient · +7 other terms	42	$234	$226	$58	25%	—	$63 – $351
12	Devoted fee schedule · outpatient · +3 other terms	35	$125	$125	$8	6%	—	$116 – $139
13	Optum fee schedule · outpatient · +5 other terms	33	$125	$302	$592	196%	—	$113 – $3.5k
14	Medcost percent of total billed charges · outpatientfrom % of charges · +4 other terms	21	$1.3k	$1.0k	$574	57%	—	$201 – $2.4k
15	Highmark facility · fee schedule · outpatient · +5 other terms	20	$117	$137	$66	48%	—	$65 – $401
16	Healthpartners fee schedule · outpatient · +1 other terms	19	$76	$78	$9	12%	—	$75 – $131
17	Oscar facility · fee schedule · outpatient · +7 other terms	19	$182	$162	$56	34%	—	$82 – $234
18	Beechstreet percent of total billed charges · outpatientfrom % of charges · +1 other terms	18	$2.2k	$2.1k	$877	42%	—	$203 – $5.1k
19	Medical Mutual facility · fee schedule · outpatient · +4 other terms	18	$140	$169	$72	43%	—	$64 – $468
20	Medicare fee schedule · outpatient · +1 other terms	18	$125	$125	—	—	—	$125 – $125
21	Tricare fee schedule · outpatient · +2 other terms	16	$121	$121	$9	8%	—	$113 – $148
22	Amerihealth Caritas percent of total billed charges · outpatientfrom % of charges · +1 other terms	15	$301	$336	$134	40%	—	$159 – $534
23	Wellmark fee schedule · both · +4 other terms	14	$65	$66	$6	9%	—	$65 – $101
24	MultiPlan fee schedule · inpatient · +9 other terms	13	$9.6k	$8.1k	$4.9k	60%	—	$1.7k – $22.7k
25	Bcbs Nc percent of total billed charges · outpatientfrom % of charges · +2 other terms	12	$598	$751	$289	39%	—	$387 – $1.4k

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