Interfyl tissue graft product, per milligram

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

INTERFYL; 1 MG

Payers reporting HCPCS Q4171

Payer pricing summary

Low

Average

$1.2k

Median

$300

High

$10.2k

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +13 other terms	384	$50	$77	$349	455%	—	$1 – $7.3k
2	Cigna fee schedule · outpatient · +15 other terms	261	$21	$53	$310	588%	—	$9 – $6.4k
3	Humana fee schedule · outpatient · +11 other terms	100	$12	$15	$9	62%	—	$1 – $48
4	Aetna fee schedule · outpatient · +15 other terms	77	$17	$388	$1.1k	293%	—	$10 – $7.7k
5	Blue Cross Blue Shield fee schedule · outpatient · +13 other terms	62	$37	$49	$42	87%	—	$1 – $188
6	Caresource fee schedule · outpatient · +7 other terms	50	$20	$30	$18	58%	—	$1 – $51
7	Molina fee schedule · outpatient · +10 other terms	31	$29	$215	$658	306%	—	$1 – $3.4k
8	Baylor Scott White Health Plan facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms	26	$9	$8	$2	20%	—	$5 – $11
9	Healthpartners fee schedule · outpatient · +1 other terms	18	$14	$14	$0	2%	—	$14 – $15
10	Anthem fee schedule · outpatient · +8 other terms	17	$53	$182	$585	321%	—	$12 – $4.4k
11	Wellmark fee schedule · both · +2 other terms	14	$12	$12	$0	2%	—	$11 – $13
12	Highmark fee schedule · outpatient · +5 other terms	13	$15	$69	$358	522%	—	$10 – $3.4k
13	WellCare professional · fee schedule · outpatient · +6 other terms	13	$10	$10	$1	5%	—	$10 – $12
14	Aetna Better Health fee schedule · outpatient · +3 other terms	12	$12	$13	$1	11%	—	$11 – $15
15	Bcbs Mn fee schedule · outpatient · +3 other terms	12	$1.2k	$787	$687	87%	—	$1 – $1.5k
16	Bcbs Nj fee schedule · outpatient	11	$28	$28	$9	33%	—	$10 – $32
17	Medical Mutual facility · fee schedule · outpatient · +4 other terms	11	$29	$29	$8	28%	—	$14 – $45
18	Medica fee schedule · outpatient · +5 other terms	10	$24	$24	$6	25%	—	$14 – $31
19	Healthcare Highways percent of total billed charges · outpatientfrom % of charges · +1 other terms	9	$6.1k	$5.3k	$7.9k	150%	—	$83 – $25.8k
20	First Health fee schedule · outpatient · +8 other terms	8	$4.6k	$6.4k	$3.3k	52%	—	$34 – $11.2k
21	Oscar facility · fee schedule · outpatient · +6 other terms	8	$13	$13	—	—	—	$13 – $13
22	Kaiser fee schedule · outpatient · +4 other terms	7	$2.9k	$2.8k	$1.6k	55%	—	$25 – $4.9k
23	Medicaid fee schedule · both · +2 other terms	7	$20	$20	—	—	—	$20 – $20
24	MultiPlan fee schedule · inpatient · +7 other terms	7	$5.1k	$9.5k	$5.0k	53%	—	$4.9k – $17.5k
25	Tricare fee schedule · both · +4 other terms	7	$10	$10	—	—	—	$10 – $10

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