NuShield 1 square centimeter wound matrix

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

Sft Tiss Grft Nushield 6x6cm (per Sqcm)

Medicaid pricing summary

Low

Average

$365

Median

$63

High

$5.4k

Medicaid rate distribution

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38 hospital rates

#		Plans
1	ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI Tehachapi, CA fee schedule · outpatient	1	$158	$158	—	—	—	$158 – $158
2	ADVENTIST HEALTH TULARE Tulare, CA fee schedule · outpatient	1	$158	$158	—	—	—	$158 – $158
3	Allina Health Systems Ulm, MN facility · other · outpatient	1	$101	$124	$94	76%	—	$32 – $282
4	Brookings Health System Brookings, SD fee schedule · outpatient	1	$1.3k	$1.3k	$546	41%	—	$428 – $1.9k
5	CATHOLIC HEALTH INITIATIVES COLORADO Salt Lake City, UT fee schedule · outpatient	1	$127	$127	—	—	—	$127 – $127
6	FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH CARMEL CARMEL, IN fee schedule · both	2	$56	$56	$5	9%	—	$51 – $61
7	FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH CRAWFORDSVILLE CRAWFORDSVILLE, IN fee schedule · both	1	$51	$51	—	—	—	$51 – $51
8	FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH CROWN POINT CROWN POINT, IN fee schedule · both	14	$51	$53	$4	8%	—	$51 – $61
9	FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH DYER DYER, IN fee schedule · both	14	$51	$53	$4	8%	—	$51 – $61
10	FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH INDIANAPOLIS INDIANAPOLIS, IN fee schedule · both	16	$51	$53	$4	8%	—	$51 – $61
11	FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH LAFAYETTE LAFAYETTE, IN fee schedule · both	2	$56	$56	$5	9%	—	$51 – $61
12	FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH MICHIGAN CITY CITY, IN fee schedule · both	2	$56	$56	$5	9%	—	$51 – $61
13	FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH MICHIGAN CITY LAPORTE PORTE, IN fee schedule · both	2	$56	$56	$5	9%	—	$51 – $61
14	FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH MOORESVILLE MOORESVILLE, IN fee schedule · both	2	$56	$56	$5	9%	—	$51 – $61
15	FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH MUNSTER MUNSTER, IN fee schedule · both	2	$56	$56	$5	9%	—	$51 – $61
16	FRANCISCAN HEALTH RENSSELAER, INC. RENSSELAER, IN fee schedule · both	2	$56	$56	$5	9%	—	$51 – $61
17	Hospital Authority of Colquitt County Moultrie, GA fee schedule · both	1	$5.4k	$5.4k	$161	3%	—	$5.3k – $5.6k
18	Hospital Service District #1, Parish of Terrebonne, State of Louisiana dba Terrebonne General Health System Houma, LA facility · other · outpatient	1	$45	$45	—	—	—	$45 – $45
19	Laredo Texas Hospital Company LP Laredo, TX facility · fee schedule · outpatient	1	$63	$63	—	—	—	$63 – $63
20	Longview Medical Center LP Longview, TX facility · fee schedule · outpatient	1	$59	$59	—	—	—	$59 – $59
21	Lowell General Hospital Lowell, MA percent of total billed charges · bothfrom % of charges	1	$235	$431	$423	98%	—	$189 – $1.6k
22	Mercy Hospital Jefferson Imperial, MO facility · percent of total billed charges · outpatientfrom % of charges	1	$83	$83	—	—	—	$83 – $83
23	Mercy Hospital South Louis, MO facility · percent of total billed charges · outpatientfrom % of charges	1	$33	$35	$17	49%	—	$19 – $74
24	Mercy Hospitals East Communities dba Mercy Hospital Washington Washington, MO facility · percent of total billed charges · outpatientfrom % of charges	1	$63	$63	$20	31%	—	$44 – $83
25	Mercy Perry Perryville, MO facility · percent of total billed charges · outpatientfrom % of charges	1	$47	$47	$16	35%	—	$28 – $80

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HCPCS Q4160