Allograft tissue, 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

Alloply, per sq cm

Payers reporting HCPCS Q4323

Payer pricing summary

Low

Average

$788

Median

$501

High

$3.2k

Payer rate distribution

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Filter by billing class

#
1	UnitedHealthcare fee schedule · outpatient · +9 other terms	404	$296	$1.2k	$1.7k	143%	—	$48 – $10.3k
2	Cigna fee schedule · outpatient · +7 other terms	245	$2.3k	$3.7k	$3.5k	97%	—	$119 – $13.5k
3	Aetna fee schedule · outpatient · +8 other terms	205	$145	$889	$2.1k	235%	—	$69 – $17.2k
4	Humana fee schedule · outpatient · +6 other terms	171	$171	$747	$723	97%	—	$48 – $1.7k
5	Blue Cross Blue Shield fee schedule · outpatient · +6 other terms	166	$125	$222	$583	263%	—	$1 – $3.0k
6	Molina fee schedule · outpatient · +6 other terms	56	$192	$251	$389	155%	—	$51 – $3.4k
7	Anthem facility · fee schedule · outpatient · +5 other terms	51	$177	$952	$1.3k	140%	—	$48 – $5.6k
8	Caresource fee schedule · outpatient · +3 other terms	48	$191	$593	$803	135%	—	$48 – $2.7k
9	WellCare fee schedule · outpatient · +5 other terms	46	$138	$269	$424	158%	—	$119 – $1.6k
10	Kaiser fee schedule · outpatient · +4 other terms	41	$207	$325	$462	142%	—	$125 – $3.5k
11	Ambetter fee schedule · outpatient · +3 other terms	38	$248	$608	$968	159%	—	$162 – $3.4k
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	Oscar facility · fee schedule · outpatient · +1 other terms	19	$234	$716	$802	112%	—	$175 – $2.0k
16	Medicare fee schedule · outpatient · +1 other terms	18	$125	$125	—	—	—	$125 – $125
17	Medical Mutual facility · fee schedule · outpatient · +2 other terms	17	$142	$2.5k	$2.3k	91%	—	$64 – $6.7k
18	Highmark fee schedule · outpatient · +4 other terms	16	$2.0k	$1.9k	$475	25%	—	$127 – $3.4k
19	Wellmark fee schedule · both · +1 other terms	14	$1.6k	$1.6k	$12	1%	—	$1.6k – $1.6k
20	Bcbs Nj fee schedule · outpatient	11	$1.6k	$1.6k	$9	1%	—	$1.6k – $1.6k
21	Regence fee schedule · outpatient · +2 other terms	10	$146	$146	$4	3%	—	$140 – $156
22	Tricare fee schedule · outpatient · +1 other terms	10	$113	$115	$4	3%	—	$113 – $121
23	Clover fee schedule · outpatient · +2 other terms	9	$140	$631	$715	113%	—	$120 – $1.6k
24	Medica fee schedule · both · +3 other terms	9	$1.8k	$1.8k	$16	1%	—	$1.8k – $1.8k
25	Excellus fee schedule · outpatient · +2 other terms	6	$236	$230	$60	26%	—	$127 – $351

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