Cogenex flowable amniotic membrane graft, 0.5 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

Cogenex flow amnion 0.5 cc

Payers reporting HCPCS Q4230

Payer pricing summary

Low

Average

$852

Median

$94

High

$7.2k

Payer rate distribution

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#
1	Blue Cross Blue Shield fee schedule · outpatient · +4 other terms	79	$22	$40	$109	275%	—	$1 – $900
2	UnitedHealthcare fee schedule · outpatient · +8 other terms	32	$869	$925	$529	57%	—	$48 – $1.9k
3	Bcbs Tx fee schedule · outpatient · +1 other terms	30	$31	$28	$9	33%	—	$12 – $49
4	Caresource fee schedule · outpatient · +1 other terms	14	$51	$50	$1	2%	—	$48 – $51
5	Anthem facility · fee schedule · outpatient · +2 other terms	11	$48	$48	$1	1%	—	$48 – $49
6	Bcbs Nj fee schedule · outpatient	10	$830	$830	—	—	—	$830 – $830
7	Medica fee schedule · outpatient · +4 other terms	10	$1.8k	$1.8k	$454	25%	—	$1.1k – $2.3k
8	Aetna other · outpatient · +3 other terms	6	$97	$93	$24	25%	—	$67 – $125
9	Bcbs La fee schedule · outpatient · +2 other terms	6	$0	$42	$190	453%	—	$0 – $900
10	Cigna other · outpatient · +1 other terms	6	$97	$91	$25	28%	—	$56 – $134
11	Aetna Better Health other · outpatient	5	$27	$31	$8	26%	—	$22 – $43
12	Amerihealth Caritas other · outpatient	5	$27	$31	$8	26%	—	$22 – $43
13	Bcbs Mn fee schedule · outpatient	5	$1	$1	$0	66%	—	$0 – $1
14	Humana other · outpatient · +1 other terms	5	$26	$34	$9	27%	—	$21 – $43
15	First Health other · outpatient · +2 other terms	3	$105	$98	$12	13%	—	$80 – $107
16	MultiPlan other · inpatient · +2 other terms	3	$77	$88	$17	20%	—	$74 – $112
17	Molina fee schedule · outpatient	2	$1.1k	$1.6k	$1.2k	73%	—	$51 – $3.4k
18	Optum facility · fee schedule · outpatient · +1 other terms	2	$4.2k	$4.2k	—	—	—	$4.2k – $4.2k
19	Bcbs Id professional · fee schedule · outpatient	1	$1	$1	—	—	—	$1 – $1
20	Highmark fee schedule · outpatient	1	$2.1k	$2.1k	$881	42%	—	$1.5k – $3.4k
21	Tricare percent of total billed charges · outpatientfrom % of charges	1	$41	$41	$2	5%	—	$39 – $43