Helicoll collagen wound dressing, 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

Helicoll, per square cm

Payers reporting HCPCS Q4164

Payer pricing summary

Low

$91

Average

$907

Median

$574

High

$3.5k

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +9 other terms	436	$307	$958	$1.2k	126%	—	$32 – $5.7k
2	Cigna fee schedule · outpatient · +8 other terms	280	$1.9k	$3.5k	$3.7k	106%	—	$119 – $14.0k
3	Aetna fee schedule · outpatient · +10 other terms	237	$147	$845	$1.7k	207%	—	$69 – $13.5k
4	Humana fee schedule · outpatient · +7 other terms	184	$312	$457	$934	204%	—	$48 – $5.1k
5	Blue Cross Blue Shield fee schedule · outpatient · +8 other terms	150	$197	$791	$1.2k	151%	—	$1 – $5.6k
6	Molina fee schedule · outpatient · +7 other terms	61	$196	$334	$492	148%	—	$51 – $3.4k
7	Anthem facility · fee schedule · outpatient · +7 other terms	56	$177	$820	$1.2k	145%	—	$7 – $5.9k
8	WellCare fee schedule · outpatient · +6 other terms	50	$140	$213	$308	145%	—	$115 – $1.7k
9	Caresource fee schedule · outpatient · +3 other terms	49	$191	$336	$631	188%	—	$48 – $2.8k
10	Kaiser fee schedule · outpatient · +5 other terms	45	$244	$624	$1.2k	198%	—	$125 – $7.5k
11	Ambetter fee schedule · outpatient · +4 other terms	42	$234	$490	$839	171%	—	$162 – $4.2k
12	Devoted fee schedule · outpatient · +3 other terms	36	$125	$125	$8	6%	—	$116 – $139
13	Optum fee schedule · outpatient · +2 other terms	32	$125	$173	$91	53%	—	$113 – $459
14	Healthpartners fee schedule · outpatient · +1 other terms	19	$2.0k	$1.9k	$298	16%	—	$131 – $2.0k
15	Oscar facility · fee schedule · outpatient · +2 other terms	19	$234	$741	$840	113%	—	$175 – $2.0k
16	Medical Mutual facility · fee schedule · outpatient · +3 other terms	18	$2.7k	$2.9k	$2.3k	81%	—	$64 – $7.0k
17	Medicare fee schedule · outpatient · +1 other terms	18	$125	$125	—	—	—	$125 – $125
18	Highmark fee schedule · outpatient · +4 other terms	16	$399	$468	$365	78%	—	$127 – $3.4k
19	Wellmark fee schedule · both · +1 other terms	14	$322	$357	$211	59%	—	$322 – $1.6k
20	Bcbs Mn fee schedule · outpatient · +3 other terms	12	$35	$60	$96	161%	—	$1 – $322
21	Aetna Better Health fee schedule · outpatient · +2 other terms	11	$1.6k	$1.6k	$16	1%	—	$1.6k – $1.7k
22	Bcbs Nj fee schedule · outpatient	11	$1.4k	$1.4k	$168	12%	—	$1.3k – $1.7k
23	Tricare fee schedule · outpatient · +1 other terms	11	$113	$118	$10	8%	—	$113 – $148
24	Medica fee schedule · outpatient · +4 other terms	10	$2.7k	$2.7k	$682	25%	—	$1.6k – $3.5k
25	Regence fee schedule · outpatient · +4 other terms	10	$146	$146	$4	3%	—	$140 – $156

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