Enverse 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

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

Payers reporting HCPCS Q4258

Payer pricing summary

Low

$55

Average

$582

Median

$196

High

$7.9k

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	UnitedHealthcare fee schedule · outpatient · +18 other terms	445	$192	$403	$809	201%	—	$48 – $8.1k
2	Cigna fee schedule · outpatient · +16 other terms	303	$137	$449	$1.0k	224%	—	$65 – $8.5k
3	Aetna fee schedule · outpatient · +17 other terms	259	$131	$407	$1.1k	278%	—	$61 – $8.9k
4	Blue Cross Blue Shield fee schedule · outpatient · +16 other terms	198	$128	$177	$256	145%	—	$1 – $4.0k
5	Humana fee schedule · outpatient · +14 other terms	185	$103	$112	$48	43%	—	$48 – $360
6	Molina fee schedule · outpatient · +15 other terms	87	$191	$246	$345	140%	—	$51 – $3.4k
7	Caresource fee schedule · outpatient · +9 other terms	61	$100	$97	$51	52%	—	$48 – $213
8	Anthem facility · fee schedule · outpatient · +16 other terms	55	$161	$165	$142	86%	—	$48 – $1.2k
9	Kaiser fee schedule · outpatient · +10 other terms	49	$244	$674	$1.1k	170%	—	$75 – $7.5k
10	WellCare fee schedule · outpatient · +9 other terms	49	$135	$130	$25	19%	—	$72 – $171
11	Ambetter facility · fee schedule · outpatient · +6 other terms	43	$212	$246	$39	16%	—	$73 – $269
12	Devoted fee schedule · outpatient · +6 other terms	34	$125	$125	$8	6%	—	$116 – $139
13	Optum fee schedule · outpatient · +8 other terms	32	$125	$171	$90	52%	—	$75 – $459
14	Bcbs Tx fee schedule · outpatient	30	$103	$106	$33	31%	—	$79 – $388
15	Baylor Scott White Health Plan facility · fee schedule · outpatient · +2 other terms	25	$158	$158	$31	20%	—	$119 – $207
16	Regence professional · fee schedule · outpatient · +6 other terms	21	$61	$66	$19	29%	—	$61 – $153
17	Superior Healthplan facility · fee schedule · outpatient · +1 other terms	21	$131	$130	$3	2%	—	$125 – $131
18	Healthpartners fee schedule · outpatient · +1 other terms	19	$88	$89	$7	8%	—	$86 – $131
19	Oscar facility · fee schedule · outpatient · +6 other terms	19	$182	$168	$48	28%	—	$102 – $234
20	Medical Mutual facility · fee schedule · outpatient · +4 other terms	18	$162	$196	$85	43%	—	$64 – $468
21	Medicare fee schedule · outpatient · +3 other terms	18	$125	$125	—	—	—	$125 – $125
22	Highmark fee schedule · outpatient · +6 other terms	16	$89	$188	$413	220%	—	$83 – $3.4k
23	Tricare fee schedule · outpatient · +3 other terms	16	$121	$122	$9	7%	—	$113 – $148
24	Medcost percent of total billed charges · bothfrom % of charges · +1 other terms	14	$188	$1.3k	$2.1k	159%	—	$177 – $7.5k
25	MultiPlan fee schedule · inpatient · +10 other terms	14	$1.6k	$2.2k	$2.2k	100%	—	$311 – $9.6k

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