Cellesta skin substitute, 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

Cellesta, 1 sq cm

Payers reporting HCPCS Q4184

Payer pricing summary

Low

Average

$382

Median

$213

High

$3.8k

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +11 other terms	437	$210	$397	$439	111%	—	$48 – $2.4k
2	Cigna fee schedule · outpatient · +8 other terms	284	$223	$502	$558	111%	—	$56 – $3.9k
3	Aetna fee schedule · outpatient · +13 other terms	247	$145	$309	$595	193%	—	$69 – $7.5k
4	Blue Cross Blue Shield fee schedule · outpatient · +8 other terms	210	$125	$323	$876	271%	—	$1 – $14.4k
5	Humana fee schedule · outpatient · +7 other terms	184	$116	$120	$84	70%	—	$48 – $624
6	Molina fee schedule · outpatient · +6 other terms	84	$200	$448	$569	127%	—	$51 – $3.4k
7	Caresource fee schedule · outpatient · +3 other terms	61	$100	$217	$321	148%	—	$48 – $1.1k
8	Anthem facility · fee schedule · outpatient · +7 other terms	55	$177	$270	$221	82%	—	$0 – $1.2k
9	WellCare fee schedule · outpatient · +5 other terms	49	$135	$153	$105	68%	—	$80 – $662
10	Kaiser fee schedule · outpatient · +5 other terms	46	$251	$344	$254	74%	—	$125 – $1.3k
11	Ambetter fee schedule · outpatient · +4 other terms	42	$234	$298	$307	103%	—	$75 – $1.7k
12	Devoted fee schedule · outpatient · +3 other terms	35	$125	$125	$8	6%	—	$116 – $139
13	Optum fee schedule · outpatient · +2 other terms	32	$125	$173	$91	53%	—	$113 – $459
14	Bcbs Tx fee schedule · outpatient	30	$8	$8	$3	31%	—	$6 – $30
15	Healthpartners fee schedule · outpatient · +1 other terms	19	$745	$729	$101	14%	—	$131 – $762
16	Oscar facility · fee schedule · outpatient · +2 other terms	19	$182	$167	$49	29%	—	$99 – $234
17	Medical Mutual facility · fee schedule · outpatient · +3 other terms	18	$158	$192	$83	43%	—	$64 – $468
18	Medicare fee schedule · outpatient · +1 other terms	18	$125	$125	—	—	—	$125 – $125
19	Highmark fee schedule · outpatient · +4 other terms	16	$99	$171	$346	203%	—	$93 – $3.4k
20	Wellmark fee schedule · both · +2 other terms	14	$80	$96	$99	103%	—	$80 – $707
21	Bcbs Nj fee schedule · outpatient	11	$516	$508	$223	44%	—	$83 – $624
22	Tricare fee schedule · outpatient · +1 other terms	11	$113	$118	$10	8%	—	$113 – $148
23	Medica fee schedule · outpatient · +6 other terms	10	$1.2k	$1.2k	$310	25%	—	$746 – $1.6k
24	Regence fee schedule · outpatient · +4 other terms	10	$146	$146	$4	3%	—	$140 – $156
25	Clover fee schedule · outpatient · +2 other terms	9	$120	$110	$22	20%	—	$80 – $140

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