Acellular dermal matrix graft, 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

HC (SUP SHELL Q4345) MATRIX HD ALLOGRFT PER SQ CM

UnitedHealthcare pricing summary

Low

$39

Average

$1.8k

Median

$210

High

$63.0k

UnitedHealthcare rate distribution

Filter by billing methodology

Filter by billing class

516 hospital rates

#		Plans
1	AMH Cath Labs LLC Arlington, TX case rate · outpatient	2	$140	$140	$1	1%	—	$139 – $142
2	ANGEL MEDICAL CENTER Franklin, NC percent of total billed charges · outpatientfrom % of charges	4	$331	$337	$125	37%	—	$128 – $599
3	Acadia Hospital Bangor, ME professional · fee schedule · outpatient	2	$3.5k	$3.5k	$836	24%	—	$2.7k – $4.4k
4	Adena Health System Chillicothe, OH facility · fee schedule · outpatient	1	$119	$119	—	—	—	$119 – $119
5	AdventHealth Avista Louisville, CO fee schedule · outpatient	1	$130	$130	—	—	—	$130 – $130
6	AdventHealth Castle Rock Castle Rock, CO fee schedule · outpatient	1	$129	$129	—	—	—	$129 – $129
7	AdventHealth Littleton Littleton, CO fee schedule · outpatient	1	$129	$129	—	—	—	$129 – $129
8	AdventHealth Parker Aurora, CO fee schedule · outpatient	1	$129	$129	—	—	—	$129 – $129
9	AdventHealth Porter Denver, CO fee schedule · outpatient	1	$129	$129	—	—	—	$129 – $129
10	Alta Newport Hospital, LLC Tustin, CA facility · fee schedule · outpatient	1	$127	$127	—	—	—	$127 – $127
11	Altru Hospital Devils Lake Devils Lake, ND facility · fee schedule · outpatient	1	$249	$249	—	—	—	$249 – $249
12	Aspirus Divine Savior Hospital Portage, WI fee schedule · outpatient	1	$210	$210	—	—	—	$210 – $210
13	Aspirus Eagle River Hospital Eagle River, WI fee schedule · outpatient	1	$210	$210	—	—	—	$210 – $210
14	Aspirus Iron River Hospital Iron River, MI fee schedule · outpatient	1	$210	$210	—	—	—	$210 – $210
15	Aspirus Ironwood Hospital Ironwood, MI fee schedule · outpatient	1	$210	$210	—	—	—	$210 – $210
16	Aspirus Keweenaw Hospital Laurium, MI fee schedule · outpatient	1	$210	$210	—	—	—	$210 – $210
17	Aspirus Langlade Hospital Antigo, WI fee schedule · outpatient	1	$210	$210	—	—	—	$210 – $210
18	Aspirus Medford Hospital Medford, WI fee schedule · outpatient	1	$210	$210	—	—	—	$210 – $210
19	Aspirus Merrill Hospital Merrill, WI fee schedule · outpatient	1	$210	$210	—	—	—	$210 – $210
20	Aspirus Rhinelander Hospital Rhinelander, WI fee schedule · outpatient	1	$210	$210	—	—	—	$210 – $210
21	Aspirus Stanley Hospital Stanley, WI fee schedule · outpatient	1	$210	$210	—	—	—	$210 – $210
22	Aspirus Stevens Point Hospital Stevens Point, WI fee schedule · outpatient	1	$210	$210	—	—	—	$210 – $210
23	Aspirus Tomahawk Hospital Tomahawk, WI fee schedule · outpatient	1	$210	$210	—	—	—	$210 – $210
24	Aspirus Wausau Hospital Wausau, WI fee schedule · outpatient	1	$210	$210	—	—	—	$210 – $210
25	Aspirus Wisconsin Rapids Hospital Wisconsin Rapids, WI fee schedule · outpatient	1	$210	$210	—	—	—	$210 – $210