Dermal matrix 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

HC (SUP SHELL Q4238) DERM-MAXX, PER SQ CM

Payers reporting HCPCS Q4238

Payer pricing summary

Low

$31

Average

$1.5k

Median

$835

High

$16.1k

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	UnitedHealthcare fee schedule · outpatient · +13 other terms	431	$296	$1.2k	$1.6k	131%	—	$48 – $10.3k
2	Cigna fee schedule · outpatient · +12 other terms	287	$2.0k	$3.6k	$3.8k	107%	—	$119 – $14.8k
3	Aetna fee schedule · outpatient · +14 other terms	242	$147	$926	$2.0k	212%	—	$69 – $18.6k
4	Blue Cross Blue Shield fee schedule · outpatient · +8 other terms	193	$149	$526	$1.0k	191%	—	$1 – $6.2k
5	Humana fee schedule · outpatient · +12 other terms	185	$1.3k	$984	$1.2k	121%	—	$48 – $6.0k
6	Molina fee schedule · outpatient · +9 other terms	84	$201	$868	$1.3k	153%	—	$51 – $3.8k
7	Caresource fee schedule · outpatient · +5 other terms	61	$1.5k	$840	$1.0k	123%	—	$48 – $2.9k
8	Anthem facility · fee schedule · outpatient · +8 other terms	56	$177	$897	$1.2k	136%	—	$48 – $5.2k
9	WellCare fee schedule · outpatient · +7 other terms	50	$138	$286	$425	149%	—	$115 – $1.6k
10	Ambetter fee schedule · outpatient · +7 other terms	42	$234	$656	$986	150%	—	$162 – $3.4k
11	Kaiser fee schedule · outpatient · +4 other terms	42	$207	$319	$425	133%	—	$125 – $3.3k
12	Devoted fee schedule · outpatient · +4 other terms	35	$125	$125	$8	6%	—	$116 – $139
13	Optum fee schedule · outpatient · +3 other terms	32	$125	$173	$91	53%	—	$113 – $459
14	Bcbs Tx fee schedule · outpatient	30	$103	$106	$33	31%	—	$79 – $388
15	Healthpartners fee schedule · outpatient · +1 other terms	19	$1.9k	$1.8k	$283	16%	—	$131 – $1.9k
16	Oscar facility · fee schedule · outpatient · +2 other terms	19	$234	$772	$888	115%	—	$175 – $2.1k
17	Medicare fee schedule · outpatient · +3 other terms	18	$125	$125	—	—	—	$125 – $125
18	Medical Mutual facility · fee schedule · outpatient · +4 other terms	17	$124	$2.5k	$2.7k	109%	—	$64 – $7.4k
19	Highmark fee schedule · outpatient · +4 other terms	16	$2.0k	$1.9k	$495	26%	—	$127 – $3.4k
20	Medica fee schedule · both · +5 other terms	15	$2.8k	$2.5k	$1.0k	41%	—	$130 – $3.4k
21	Wellmark fee schedule · both · +2 other terms	14	$1.5k	$1.5k	$36	2%	—	$1.5k – $1.7k
22	Tricare fee schedule · outpatient · +2 other terms	12	$113	$119	$10	8%	—	$113 – $148
23	Aetna Better Health fee schedule · outpatient · +3 other terms	11	$1.4k	$1.6k	$279	17%	—	$1.4k – $2.0k
24	Bcbs Nj fee schedule · outpatient	11	$1.5k	$1.5k	$21	1%	—	$1.5k – $1.6k
25	Regence fee schedule · outpatient · +4 other terms	10	$146	$146	$4	3%	—	$140 – $156

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