Skin substitute product, not otherwise specified

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

Pma skin substitute product, not otherwise specified (list in addition to primary procedure)

Payers reporting HCPCS Q4431

Payer pricing summary

Low

$39

Average

$918

Median

$140

High

$6.4k

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +8 other terms	218	$210	$231	$68	29%	—	$1 – $483
2	Aetna facility · fee schedule · outpatient · +7 other terms	54	$125	$127	$9	7%	—	$118 – $160
3	Humana fee schedule · outpatient · +6 other terms	41	$127	$132	$24	18%	—	$1 – $171
4	First Health facility · percent of total billed charges · bothfrom % of charges · +3 other terms	35	$77	$79	$25	32%	—	$31 – $171
5	Molina facility · fee schedule · outpatient · +5 other terms	33	$124	$134	$50	37%	—	$65 – $319
6	Blue Cross Blue Shield fee schedule · outpatient · +7 other terms	32	$16	$19	$19	99%	—	$9 – $160
7	MultiPlan facility · percent of total billed charges · bothfrom % of charges · +1 other terms	32	$94	$91	$27	30%	—	$42 – $162
8	Cigna fee schedule · outpatient · +10 other terms	28	$275	$280	$176	63%	—	$125 – $644
9	WellCare fee schedule · outpatient · +4 other terms	28	$141	$142	$10	7%	—	$127 – $158
10	Phcs facility · percent of total billed charges · bothfrom % of charges · +1 other terms	27	$84	$81	$17	21%	—	$42 – $99
11	Devoted facility · fee schedule · outpatient · +2 other terms	23	$118	$124	$11	9%	—	$118 – $143
12	Anthem fee schedule · outpatient · +6 other terms	22	$140	$295	$314	106%	—	$123 – $911
13	Kaiser fee schedule · outpatient · +4 other terms	22	$125	$307	$247	80%	—	$125 – $1000
14	Ambetter fee schedule · outpatient · +3 other terms	18	$256	$263	$41	16%	—	$218 – $351
15	Medicare fee schedule · outpatient · +1 other terms	18	$125	$125	—	—	—	$125 – $125
16	Caresource facility · fee schedule · outpatient · +3 other terms	15	$212	$178	$42	23%	—	$121 – $238
17	Medcost facility · percent of total billed charges · bothfrom % of charges · +1 other terms	14	$67	$71	$14	20%	—	$58 – $95
18	Medica facility · percent of total billed charges · bothfrom % of charges	13	$94	$89	$16	18%	—	$68 – $120
19	Medical Mutual facility · fee schedule · outpatient · +2 other terms	12	$118	$123	$13	11%	—	$118 – $167
20	Optum fee schedule · outpatient · +1 other terms	12	$125	$180	$125	69%	—	$125 – $459
21	Beechstreet percent of total billed charges · bothfrom % of charges	10	$3.4k	$3.6k	$3.3k	91%	—	$159 – $7.5k
22	Magellan facility · percent of total billed charges · bothfrom % of charges	9	$74	$80	$48	59%	—	$31 – $170
23	Regence fee schedule · outpatient · +4 other terms	9	$146	$145	$3	2%	—	$140 – $150
24	Excellus fee schedule · outpatient · +3 other terms	6	$236	$230	$60	26%	—	$127 – $351
25	Amerihealth Caritas facility · percent of total billed charges · bothfrom % of charges	5	$60	$60	$22	36%	—	$31 – $95

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