Renograft 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

Renograft per sq cm

Payers reporting HCPCS Q4321

Payer pricing summary

Low

Average

$900

Median

$187

High

$7.4k

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +8 other terms	273	$210	$870	$2.0k	226%	—	$48 – $7.1k
2	Cigna fee schedule · outpatient · +5 other terms	130	$4.4k	$8.4k	$8.5k	101%	—	$119 – $26.2k
3	Aetna fee schedule · outpatient · +8 other terms	129	$132	$588	$1.6k	272%	—	$69 – $10.7k
4	Blue Cross Blue Shield fee schedule · outpatient · +6 other terms	109	$69	$44	$63	142%	—	$1 – $361
5	Humana fee schedule · outpatient · +6 other terms	69	$125	$126	$15	12%	—	$48 – $171
6	WellCare fee schedule · outpatient · +5 other terms	40	$136	$138	$14	10%	—	$119 – $171
7	Anthem facility · fee schedule · outpatient · +4 other terms	34	$118	$1.6k	$3.6k	234%	—	$48 – $13.7k
8	Molina facility · fee schedule · outpatient · +6 other terms	34	$118	$129	$50	39%	—	$65 – $319
9	Devoted fee schedule · outpatient · +3 other terms	32	$125	$124	$7	6%	—	$116 – $136
10	Optum fee schedule · outpatient · +2 other terms	32	$125	$173	$91	53%	—	$113 – $459
11	Ambetter fee schedule · outpatient · +3 other terms	30	$240	$255	$38	15%	—	$193 – $351
12	Bcbs Tx fee schedule · outpatient	30	$8	$8	$3	31%	—	$6 – $30
13	Kaiser fee schedule · outpatient · +4 other terms	27	$207	$281	$217	77%	—	$125 – $1000
14	Medicare fee schedule · outpatient · +1 other terms	18	$125	$125	—	—	—	$125 – $125
15	Caresource fee schedule · outpatient · +3 other terms	17	$100	$87	$57	65%	—	$48 – $199
16	Medical Mutual facility · fee schedule · outpatient · +1 other terms	13	$118	$123	$13	10%	—	$118 – $167
17	Bcbs Nj fee schedule · outpatient	11	$4.0k	$4.0k	—	—	—	$4.0k – $4.0k
18	Oscar facility · fee schedule · outpatient · +1 other terms	11	$175	$177	$3	2%	—	$175 – $182
19	Regence fee schedule · outpatient · +2 other terms	10	$146	$146	$4	3%	—	$140 – $156
20	Tricare fee schedule · outpatient · +1 other terms	10	$113	$115	$4	3%	—	$113 – $121
21	Excellus fee schedule · outpatient · +2 other terms	6	$236	$230	$60	26%	—	$127 – $351
22	Highmark fee schedule · outpatient · +3 other terms	6	$176	$1.6k	$1.6k	106%	—	$127 – $4.1k
23	Aetna Better Health facility · fee schedule · outpatient	5	$68	$68	$1	1%	—	$68 – $70
24	Clover fee schedule · outpatient · +1 other terms	5	$120	$125	$9	7%	—	$120 – $140
25	First Health professional · fee schedule · both · +1 other terms	3	$4.2k	$4.2k	—	—	—	$4.2k – $4.2k

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