Vim 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-sonnet-5-5
Provider: anthropic
API: message_batches
Reasoning effort: model default
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Vim, per square centimeter

Payers reporting HCPCS Q4251

Payer pricing summary

Low

Average

$163

Median

$148

High

$366

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	UnitedHealthcare fee schedule · outpatient · +9 other terms	415	$210	$254	$144	57%	—	$48 – $1.1k
2	Cigna fee schedule · outpatient · +7 other terms	217	$257	$426	$334	78%	—	$119 – $1.3k
3	Aetna fee schedule · outpatient · +9 other terms	215	$144	$189	$158	83%	—	$69 – $1.6k
4	Blue Cross Blue Shield fee schedule · outpatient · +6 other terms	164	$122	$86	$104	121%	—	$1 – $580
5	Humana fee schedule · outpatient · +6 other terms	96	$127	$162	$107	66%	—	$48 – $580
6	Molina fee schedule · outpatient · +6 other terms	55	$192	$251	$386	154%	—	$51 – $3.4k
7	WellCare fee schedule · outpatient · +4 other terms	46	$136	$139	$14	10%	—	$115 – $171
8	Kaiser fee schedule · outpatient · +3 other terms	39	$207	$267	$185	69%	—	$125 – $1000
9	Anthem facility · fee schedule · outpatient · +4 other terms	35	$118	$198	$184	93%	—	$48 – $1.2k
10	Ambetter fee schedule · outpatient · +2 other terms	34	$234	$245	$45	18%	—	$162 – $351
11	Devoted fee schedule · outpatient · +3 other terms	33	$125	$125	$7	6%	—	$116 – $136
12	Optum fee schedule · outpatient · +1 other terms	32	$125	$173	$91	53%	—	$113 – $459
13	Bcbs Tx fee schedule · outpatient	30	$8	$8	$3	31%	—	$6 – $30
14	Caresource fee schedule · outpatient · +2 other terms	24	$100	$94	$65	69%	—	$48 – $213
15	Oscar facility · fee schedule · outpatient · +1 other terms	19	$182	$196	$25	13%	—	$175 – $234
16	Medicare fee schedule · outpatient	18	$125	$125	—	—	—	$125 – $125
17	Highmark fee schedule · outpatient · +4 other terms	16	$168	$215	$327	152%	—	$127 – $3.4k
18	Medical Mutual facility · fee schedule · outpatient · +2 other terms	14	$118	$150	$96	64%	—	$64 – $468
19	Wellmark fee schedule · both · +2 other terms	13	$180	$179	$5	3%	—	$151 – $180
20	Bcbs Nj fee schedule · outpatient	12	$149	$149	—	—	—	$149 – $149
21	Tricare fee schedule · outpatient · +1 other terms	11	$113	$118	$10	8%	—	$113 – $148
22	Medica fee schedule · outpatient · +4 other terms	10	$376	$379	$95	25%	—	$228 – $486
23	Regence fee schedule · outpatient · +4 other terms	10	$146	$146	$4	3%	—	$140 – $156
24	Clover facility · fee schedule · outpatient · +1 other terms	8	$123	$123	$6	5%	—	$117 – $134
25	Aetna Better Health fee schedule · inpatient · +2 other terms	7	$148	$148	—	—	—	$148 – $148

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