RC 623

Surgical dressings and supplies

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 DRESSING MEPITEL T2

Payers reporting RC 623

Payer pricing summary

Low

Average

$173

Median

$67

High

$1.1k

Payer rate distribution

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#
1	Bcbs Il percent of total billed charges · bothfrom % of charges	7	$11	$31	$39	126%	770–986	$2 – $249
2	Healthpartners facility · case rate · both · +5 other terms	1	$90	$90	—	—	1–10	$90 – $90
3	Aetna fee schedule · outpatient · +19 other terms	30	$0	$225	$647	288%	—	$0 – $3.0k
4	MultiPlan fee schedule · inpatient · +12 other terms	26	$31	$456	$925	203%	—	$1 – $3.1k
5	UnitedHealthcare fee schedule · outpatient · +22 other terms	26	$17	$75	$316	421%	—	$0 – $2.8k
6	Medica fee schedule · outpatient · +10 other terms	25	$21	$25	$20	80%	—	$0 – $71
7	Blue Cross Blue Shield fee schedule · outpatient · +16 other terms	16	$10	$26	$116	445%	—	$0 – $1.4k
8	Humana fee schedule · outpatient · +13 other terms	16	$11	$16	$51	330%	—	$0 – $656
9	Anthem facility · case rate · outpatient · +13 other terms	13	$15	$18	$11	60%	—	$1 – $65
10	Molina facility · case rate · outpatient · +16 other terms	13	$15	$16	$12	76%	—	$0 – $65
11	Caresource facility · case rate · outpatient · +5 other terms	12	$15	$18	$10	55%	—	$9 – $62
12	Optum facility · case rate · outpatient · +6 other terms	10	$14	$16	$10	64%	—	$1 – $59
13	Phcs fee schedule · inpatient · +9 other terms	10	$32	$26	$21	81%	—	$8 – $72
14	Ucare fee schedule · outpatient · +6 other terms	9	$23	$10	$10	95%	—	$0 – $31
15	Wellmark case rate · outpatient · +5 other terms	8	$17	$27	$34	130%	—	$9 – $137
16	Bcbs Mn fee schedule · outpatient · +3 other terms	7	$21	$21	$7	33%	—	$11 – $26
17	Aetna Better Health fee schedule · outpatient · +5 other terms	5	$15	$11	$15	129%	—	$0 – $80
18	Highmark facility · fee schedule · outpatient · +9 other terms	5	$46	$40	$37	94%	—	$0 – $176
19	Medicaid fee schedule · outpatient · +1 other terms	5	$23	$21	$20	93%	—	$1 – $77
20	Medicare facility · percent of total billed charges · outpatientfrom % of charges	5	$33	$35	$13	38%	—	$17 – $56
21	Ambetter case rate · outpatient · +4 other terms	3	$14	$14	—	—	—	$14 – $14
22	Amerihealth Caritas fee schedule · both · +3 other terms	3	$57	$57	$5	8%	—	$52 – $62
23	Cigna facility · other · outpatient · +14 other terms	3	$12	$12	—	—	—	$12 – $12
24	Clover facility · other · outpatient · +2 other terms	3	$13	$13	—	—	—	$13 – $13
25	Kaiser fee schedule · outpatient · +10 other terms	3	$512	$772	$694	90%	—	$5 – $2.0k

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