Skin substitute 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-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

Skin te, per square centimeter (add-on, list separately in addition to primary procedure)

WellCare pricing summary

Low

$67

Average

$233

Median

$127

High

$6.5k

WellCare rate distribution

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100 hospital rates

#		Plans
1	AMH Cath Labs LLC Arlington, TX case rate · outpatient	2	$135	$135	$3	2%	—	$131 – $138
2	Affinity Hospital LLC Birmingham, AL facility · fee schedule · outpatient	2	$143	$143	$27	19%	—	$116 – $171
3	CLAIBORNE MEDICAL CENTER Tazewell, TN fee schedule · outpatient	1	$127	$127	—	—	—	$127 – $127
4	CLOVIS COMMUNITY MEDICAL CENTER Clovis, CA facility · case rate · outpatient	1	$160	$160	—	—	—	$160 – $160
5	CUMBERLAND MEDICAL CENTER, INC. Crossville, TN fee schedule · outpatient	1	$127	$127	—	—	—	$127 – $127
6	Canton-Potsdam Hospital Potsdam, NY facility · fee schedule · outpatient	2	$123	$123	—	—	—	$123 – $123
7	Carle BroMenn Medical Center Normal, IL case rate · outpatient	1	$133	$133	—	—	—	$133 – $133
8	Carle Eureka Hospital Eureka, IL case rate · outpatient	1	$133	$133	—	—	—	$133 – $133
9	Central Maine Medical Center Lewiston, ME fee schedule · outpatient	1	$127	$127	—	—	—	$127 – $127
10	Clallam County Public Hospital District 2 DBA Olympic Medical Center Port Angeles, WA fee schedule · outpatient	1	$171	$171	—	—	—	$171 – $171
11	Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · fee schedule · outpatient	1	$130	$130	—	—	—	$130 – $130
12	ERIE COUNTY MEDICAL CENTER CORPORATION Buffalo, NY fee schedule · outpatient	1	$155	$155	—	—	—	$155 – $155
13	F.F. Thompson Hospital Canandaigua, NY fee schedule · outpatient	1	$127	$127	—	—	—	$127 – $127
14	FORT LOUDOUN MEDICAL CENTER Lenoir City, TN fee schedule · outpatient	1	$119	$119	—	—	—	$119 – $119
15	FORT SANDERS REGIONAL MEDICAL CENTER Knoxville, TN fee schedule · outpatient	1	$119	$119	—	—	—	$119 – $119
16	FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER Fresno, CA facility · fee schedule · outpatient	1	$127	$127	—	—	—	$127 – $127
17	Good Samaritan Hospital Puyallup, WA fee schedule · outpatient	1	$149	$149	—	—	—	$149 – $149
18	HMH HOSPITALS CORPORATION Hackensack, NJ facility · percent of total billed charges · outpatientfrom % of charges	2	$67	$67	—	—	—	$67 – $67
19	HMH HOSPITALS CORPORATION Red Bank, NJ facility · percent of total billed charges · outpatientfrom % of charges	2	$67	$67	—	—	—	$67 – $67
20	HMH HOSPITALS CORPORATION Edison, NJ facility · percent of total billed charges · outpatientfrom % of charges	2	$67	$67	—	—	—	$67 – $67
21	HMH HOSPITALS CORPORATION Manahawkin, NJ facility · percent of total billed charges · bothfrom % of charges	2	$67	$67	—	—	—	$67 – $67
22	HMH HOSPITALS CORPORATION Brick, NJ facility · percent of total billed charges · outpatientfrom % of charges	2	$67	$67	—	—	—	$67 – $67
23	HMH HOSPITALS CORPORATION Neptune City, NJ facility · percent of total billed charges · outpatientfrom % of charges	2	$67	$67	—	—	—	$67 – $67
24	HMH HOSPITALS CORPORATION Edison, NJ facility · percent of total billed charges · outpatientfrom % of charges	2	$67	$67	—	—	—	$67 – $67
25	HMH HOSPITALS CORPORATION North Bergen, NJ facility · percent of total billed charges · bothfrom % of charges	2	$67	$67	—	—	—	$67 – $67