Surgical adhesion barrier film, small incision at Aurora Medical Center Summit

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

1086120 - BARRIER ADH 4X3IN ABS CNTRL BYND CLSR GYNECARE INTCD PLVC

Summit, WI

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How this price compares nationally

Aurora Medical Center Summit’s median price of $613 is 28% below the median hospital's median price ($848), higher than 33% of the 1,278 hospitals reporting HCPCS C1765. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS C1765 at Aurora Medical Center Summit

Negotiated rates from the hospital’s own file: 6 payers, 21 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.

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1	Aetna hmo percent of total billed charges · outpatientfrom % of charges	$458	$458	—	—	—	$458 – $458
2	UnitedHealthcare charter percent of total billed charges · outpatientfrom % of charges	$560	$560	—	—	—	$560 – $560
3	UnitedHealthcare exchange percent of total billed charges · outpatientfrom % of charges	$560	$560	—	—	—	$560 – $560
4	UnitedHealthcare hmo percent of total billed charges · outpatientfrom % of charges	$560	$560	—	—	—	$560 – $560
5	UnitedHealthcare nexus percent of total billed charges · outpatientfrom % of charges	$560	$560	—	—	—	$560 – $560
6	Anthem blue priority percent of total billed charges · outpatientfrom % of charges	$566	$566	—	—	—	$566 – $566
7	Healthpartners employee trust fund percent of total billed charges · outpatientfrom % of charges	$566	$566	—	—	—	$566 – $566
8	Molina commercial percent of total billed charges · outpatientfrom % of charges	$566	$566	—	—	—	$566 – $566
9	Anthem blue preferred percent of total billed charges · outpatientfrom % of charges	$613	$613	—	—	—	$613 – $613
10	Cigna ppo-gppo percent of total billed charges · outpatientfrom % of charges	$707	$707	—	—	—	$707 – $707
11	Healthpartners broad percent of total billed charges · inpatientfrom % of charges	$707	$707	—	—	—	$707 – $707
12	Healthpartners broad percent of total billed charges · outpatientfrom % of charges	$707	$707	—	—	—	$707 – $707
13	Healthpartners robin percent of total billed charges · outpatientfrom % of charges	$707	$707	—	—	—	$707 – $707
14	Aetna ppo percent of total billed charges · inpatientfrom % of charges	$779	$779	—	—	—	$779 – $779
15	Aetna ppo percent of total billed charges · outpatientfrom % of charges	$779	$779	—	—	—	$779 – $779
16	UnitedHealthcare ppo percent of total billed charges · inpatientfrom % of charges	$794	$794	—	—	—	$794 – $794
17	UnitedHealthcare ppo percent of total billed charges · outpatientfrom % of charges	$794	$794	—	—	—	$794 – $794
18	Cigna ppo percent of total billed charges · inpatientfrom % of charges	$798	$798	—	—	—	$798 – $798
19	Cigna ppo percent of total billed charges · outpatientfrom % of charges	$798	$798	—	—	—	$798 – $798
20	Anthem ppo percent of total billed charges · inpatientfrom % of charges	$801	$801	—	—	—	$801 – $801
21	Anthem ppo percent of total billed charges · outpatientfrom % of charges	$801	$801	—	—	—	$801 – $801

Last updated: Nov 21, 2025

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