FlowerAmnioFlo amniotic product, 0.1 cc

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

Floweramnioflo, 0.1 cc

Payers reporting HCPCS Q4177

Payer pricing summary

Low

Average

$595

Median

$332

High

$3.6k

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	UnitedHealthcare fee schedule · outpatient · +8 other terms	373	$297	$320	$151	47%	—	$48 – $1.1k
2	Cigna fee schedule · outpatient · +8 other terms	172	$289	$484	$338	70%	—	$153 – $1.3k
3	Blue Cross Blue Shield fee schedule · outpatient · +10 other terms	89	$545	$574	$257	45%	—	$1 – $1.2k
4	Aetna fee schedule · outpatient · +10 other terms	57	$148	$284	$256	90%	—	$144 – $1.6k
5	Bcbs Tx fee schedule · outpatient · +1 other terms	30	$780	$708	$236	33%	—	$290 – $1.2k
6	Baylor Scott White Health Plan facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms	26	$371	$330	$81	25%	—	$210 – $476
7	Superior Healthplan facility · percent of total billed charges · outpatientfrom % of charges	25	$86	$92	$35	38%	—	$37 – $211
8	Anthem facility · fee schedule · outpatient · +4 other terms	14	$48	$211	$130	62%	—	$0 – $355
9	Caresource fee schedule · outpatient · +4 other terms	14	$51	$50	$1	2%	—	$48 – $51
10	Ambetter facility · percent of total billed charges · outpatientfrom % of charges	13	$373	$373	$69	19%	—	$304 – $442
11	Wellmark fee schedule · both · +2 other terms	13	$180	$179	$5	3%	—	$151 – $180
12	Bcbs Nj fee schedule · outpatient	12	$149	$149	—	—	—	$149 – $149
13	Highmark fee schedule · outpatient · +3 other terms	12	$168	$218	$337	155%	—	$153 – $3.4k
14	Medica fee schedule · outpatient · +7 other terms	10	$376	$379	$95	25%	—	$228 – $486
15	Aetna Better Health fee schedule · inpatient · +1 other terms	7	$148	$148	—	—	—	$148 – $148
16	MultiPlan percent of total billed charges · outpatientfrom % of charges · +3 other terms	7	$896	$5.0k	$4.6k	93%	—	$896 – $11.7k
17	Bcbs La fee schedule · outpatient · +1 other terms	6	$162	$162	—	—	—	$162 – $162
18	Humana fee schedule · outpatient · +4 other terms	6	$144	$128	$36	28%	—	$48 – $144
19	Bcbs Mn fee schedule · outpatient	5	$1	$1	$0	66%	—	$0 – $1
20	Excellus facility · fee schedule · outpatient	5	$270	$298	$155	52%	—	$191 – $716
21	Oscar percent of total billed charges · inpatientfrom % of charges · +1 other terms	5	$527	$527	—	—	—	$527 – $527
22	Phcs percent of total billed charges · outpatientfrom % of charges	5	$791	$791	—	—	—	$791 – $791
23	Tricare fee schedule · outpatient	5	$1.1k	$1.1k	—	—	—	$1.1k – $1.1k
24	First Health facility · fee schedule · outpatient · +3 other terms	4	$450	$450	—	—	—	$450 – $450
25	Molina fee schedule · outpatient · +2 other terms	2	$1.1k	$1.6k	$1.2k	73%	—	$51 – $3.4k

Page 1 of 2 · 35 payers