Skin substitute matrix, 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

VIA MATRIX, PER SQ CM

Payers reporting HCPCS Q4309

Payer pricing summary

Low

$68

Average

$8.5k

Median

$874

High

$91.9k

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	UnitedHealthcare fee schedule · outpatient · +13 other terms	417	$296	$1.3k	$1.8k	138%	—	$48 – $8.3k
2	Cigna fee schedule · outpatient · +9 other terms	258	$1.9k	$3.2k	$2.9k	92%	—	$119 – $11.2k
3	Aetna fee schedule · outpatient · +14 other terms	205	$145	$815	$2.0k	248%	—	$69 – $18.2k
4	Humana fee schedule · outpatient · +11 other terms	170	$170	$619	$571	92%	—	$48 – $1.4k
5	Blue Cross Blue Shield fee schedule · outpatient · +11 other terms	166	$255	$8.4k	$7.5k	89%	—	$1 – $24.5k
6	Molina fee schedule · outpatient · +8 other terms	55	$192	$252	$393	156%	—	$51 – $3.4k
7	Anthem facility · fee schedule · outpatient · +8 other terms	51	$177	$718	$880	123%	—	$48 – $3.5k
8	Caresource fee schedule · outpatient · +4 other terms	48	$191	$496	$650	131%	—	$48 – $2.2k
9	WellCare fee schedule · outpatient · +6 other terms	45	$136	$243	$338	139%	—	$119 – $1.3k
10	Kaiser fee schedule · outpatient · +5 other terms	41	$207	$329	$488	149%	—	$125 – $3.7k
11	Ambetter fee schedule · outpatient · +4 other terms	38	$248	$532	$766	144%	—	$162 – $2.7k
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	$11.0k	$11.4k	$3.6k	31%	—	$8.4k – $41.6k
15	Oscar facility · fee schedule · outpatient · +1 other terms	19	$234	$619	$652	105%	—	$175 – $1.6k
16	Medicare fee schedule · outpatient · +2 other terms	18	$125	$125	—	—	—	$125 – $125
17	Medical Mutual facility · fee schedule · outpatient · +2 other terms	17	$142	$2.1k	$1.9k	90%	—	$64 – $5.6k
18	Highmark fee schedule · outpatient · +6 other terms	16	$1.6k	$1.6k	$402	26%	—	$127 – $3.4k
19	Phcs percent of total billed charges · bothfrom % of charges	15	$77.5k	$73.5k	$36.1k	49%	—	$20.8k – $140.2k
20	Wellmark fee schedule · both · +3 other terms	14	$1.8k	$1.7k	$71	4%	—	$1.3k – $1.8k
21	Bcbs Nj fee schedule · outpatient	11	$1.6k	$1.6k	$341	22%	—	$913 – $1.7k
22	Medica facility · fee schedule · outpatient · +4 other terms	11	$133	$324	$477	147%	—	$132 – $2.5k
23	Beechstreet percent of total billed charges · bothfrom % of charges	10	$88.6k	$91.9k	$42.3k	46%	—	$37.8k – $159.0k
24	Regence fee schedule · outpatient · +2 other terms	10	$146	$146	$4	3%	—	$140 – $156
25	Tricare fee schedule · outpatient · +1 other terms	10	$113	$115	$4	3%	—	$113 – $121

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