Keramatrix or Kerasorb wound 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

KERAMATRIX, KERASORB SQ CM

Payers reporting HCPCS Q4165

Payer pricing summary

Low

$30

Average

$141

Median

$125

High

$1.2k

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	UnitedHealthcare fee schedule · outpatient · +9 other terms	416	$210	$1.5k	$3.5k	241%	—	$12 – $26.3k
2	Aetna fee schedule · outpatient · +9 other terms	222	$126	$129	$68	53%	—	$29 – $515
3	Cigna fee schedule · outpatient · +7 other terms	217	$105	$148	$105	71%	—	$31 – $644
4	Blue Cross Blue Shield fee schedule · outpatient · +7 other terms	115	$125	$142	$103	73%	—	$1 – $580
5	Humana fee schedule · outpatient · +7 other terms	95	$125	$121	$37	30%	—	$29 – $360
6	Anthem facility · fee schedule · outpatient · +4 other terms	54	$130	$184	$161	87%	—	$7 – $1.2k
7	Molina fee schedule · outpatient · +6 other terms	54	$192	$242	$395	163%	—	$30 – $3.4k
8	WellCare fee schedule · outpatient · +4 other terms	46	$136	$138	$14	10%	—	$115 – $171
9	Kaiser fee schedule · outpatient · +3 other terms	39	$207	$262	$187	71%	—	$64 – $1000
10	Ambetter fee schedule · outpatient · +2 other terms	34	$234	$245	$45	18%	—	$162 – $351
11	Devoted fee schedule · outpatient · +3 other terms	34	$125	$125	$8	6%	—	$116 – $139
12	Optum fee schedule · outpatient · +1 other terms	32	$125	$173	$91	53%	—	$113 – $459
13	Caresource fee schedule · outpatient · +2 other terms	24	$100	$90	$63	70%	—	$48 – $213
14	Oscar facility · fee schedule · outpatient · +1 other terms	19	$182	$196	$25	13%	—	$175 – $234
15	Medicare fee schedule · outpatient	18	$125	$125	—	—	—	$125 – $125
16	Highmark fee schedule · outpatient · +4 other terms	16	$50	$108	$344	317%	—	$39 – $3.4k
17	Medical Mutual facility · fee schedule · outpatient · +2 other terms	14	$118	$150	$96	64%	—	$64 – $468
18	Wellmark fee schedule · both · +2 other terms	13	$30	$30	$0	0%	—	$30 – $30
19	Bcbs Mn fee schedule · outpatient · +3 other terms	12	$105	$71	$55	78%	—	$1 – $132
20	Bcbs Nj fee schedule · outpatient	12	$30	$30	—	—	—	$30 – $30
21	Tricare fee schedule · outpatient · +1 other terms	11	$113	$118	$10	8%	—	$113 – $148
22	Medica fee schedule · outpatient · +4 other terms	10	$63	$63	$16	25%	—	$38 – $81
23	Regence fee schedule · outpatient · +4 other terms	10	$146	$146	$4	3%	—	$140 – $156
24	Ucare fee schedule · both · +1 other terms	9	$48	$48	—	—	—	$48 – $48
25	Clover facility · fee schedule · outpatient · +1 other terms	8	$123	$123	$6	5%	—	$117 – $134

Page 1 of 2 · 45 payers