Acesso DL product, per square centimeter (add-on)

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

Acesso dl, per sq cm

Payers reporting HCPCS Q4293

Payer pricing summary

Low

Average

$781

Median

$566

High

$3.1k

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	UnitedHealthcare fee schedule · outpatient · +9 other terms	418	$296	$1.2k	$1.6k	132%	—	$48 – $9.9k
2	Cigna fee schedule · outpatient · +7 other terms	263	$1.9k	$3.6k	$3.5k	99%	—	$119 – $13.6k
3	Aetna fee schedule · outpatient · +9 other terms	210	$145	$815	$1.8k	220%	—	$69 – $13.0k
4	Blue Cross Blue Shield fee schedule · outpatient · +6 other terms	175	$125	$290	$618	213%	—	$1 – $2.9k
5	Humana fee schedule · outpatient · +6 other terms	169	$170	$728	$697	96%	—	$48 – $1.7k
6	Molina fee schedule · outpatient · +6 other terms	53	$192	$254	$403	159%	—	$51 – $3.4k
7	Anthem facility · fee schedule · outpatient · +5 other terms	52	$177	$944	$1.3k	141%	—	$48 – $5.7k
8	Caresource fee schedule · outpatient · +3 other terms	49	$191	$578	$787	136%	—	$48 – $2.7k
9	WellCare fee schedule · outpatient · +5 other terms	48	$140	$315	$481	153%	—	$115 – $1.7k
10	Kaiser fee schedule · outpatient · +4 other terms	41	$207	$310	$361	117%	—	$125 – $2.7k
11	Ambetter fee schedule · outpatient · +3 other terms	38	$248	$595	$933	157%	—	$162 – $3.2k
12	Devoted fee schedule · outpatient · +3 other terms	34	$125	$125	$8	6%	—	$116 – $139
13	Optum fee schedule · outpatient · +2 other terms	32	$125	$173	$91	53%	—	$113 – $459
14	Bcbs Tx fee schedule · outpatient	30	$8	$8	$3	31%	—	$6 – $30
15	Healthpartners fee schedule · outpatient · +1 other terms	19	$1.9k	$1.8k	$289	16%	—	$131 – $1.9k
16	Oscar facility · fee schedule · outpatient · +2 other terms	19	$234	$720	$808	112%	—	$175 – $2.0k
17	Medicare fee schedule · outpatient · +1 other terms	18	$125	$125	—	—	—	$125 – $125
18	Medical Mutual facility · fee schedule · outpatient · +2 other terms	17	$142	$2.5k	$2.3k	91%	—	$64 – $6.8k
19	Highmark fee schedule · outpatient · +4 other terms	16	$2.0k	$1.8k	$467	26%	—	$127 – $3.4k
20	Wellmark fee schedule · both · +1 other terms	14	$1.5k	$1.5k	$14	1%	—	$1.5k – $1.6k
21	Bcbs Nj fee schedule · outpatient	11	$1.3k	$1.3k	$166	13%	—	$1.2k – $1.6k
22	Tricare fee schedule · outpatient · +1 other terms	11	$113	$118	$10	8%	—	$113 – $148
23	Regence fee schedule · outpatient · +3 other terms	10	$146	$146	$4	3%	—	$140 – $156
24	Clover fee schedule · outpatient · +2 other terms	9	$140	$612	$688	112%	—	$120 – $1.6k
25	Medica fee schedule · both · +3 other terms	9	$1.6k	$1.6k	$15	1%	—	$1.6k – $1.7k

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