Allowrap dressing, per square centimeter at Samaritan Hospital

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

BONE ALLOWRAP DS 4X8 NACL-COST PER SQ CM

Troy, NY

See all hospitals reporting HCPCS Q4150 →

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Pricing by billing methodology

Price type

How this price compares nationally

Samaritan Hospital’s median price of $189 is 11% above the median hospital's median price ($170), higher than 54% of the 1,240 hospitals reporting HCPCS Q4150. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS Q4150 at Samaritan Hospital

Negotiated rates from the hospital’s own file: 12 payers, 17 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 aetna medicare advantage facility · percent of total billed charges · bothfrom % of charges	$62	$74	$35	47%	—	$43 – $145
2	UnitedHealthcare uhc essential plan medicaid facility · percent of total billed charges · bothfrom % of charges	$99	$119	$56	47%	—	$69 – $233
3	UnitedHealthcare united healthcare medicaid harp chip facility · percent of total billed charges · bothfrom % of charges	$99	$119	$56	47%	—	$69 – $233
4	Excellus blue shield of ne new york medicare adv facility · percent of total billed charges · bothfrom % of charges	$123	$149	$70	47%	—	$86 – $291
5	Highmark blue shield of ne new york medicare adv facility · percent of total billed charges · bothfrom % of charges	$123	$149	$70	47%	—	$86 – $291
6	Anthem empire bcbs blue access facility · percent of total billed charges · bothfrom % of charges	$185	$223	$105	47%	—	$129 – $436
7	Anthem empire bcbs hmo epo ppo indemnity facility · percent of total billed charges · bothfrom % of charges	$185	$223	$105	47%	—	$129 – $436
8	Blue Cross Blue Shield empire bcbs hmo epo ppo indemnity facility · percent of total billed charges · bothfrom % of charges	$185	$223	$105	47%	—	$129 – $436
9	UnitedHealthcare empire bcbs hmo epo ppo indemnity facility · percent of total billed charges · bothfrom % of charges	$185	$223	$105	47%	—	$129 – $436
10	WellCare wellcare ep 1&2 medicaid facility · percent of total billed charges · bothfrom % of charges	$185	$223	$105	47%	—	$129 – $436
11	Wellmark empire bcbs hmo epo ppo indemnity facility · percent of total billed charges · bothfrom % of charges	$185	$223	$105	47%	—	$129 – $436
12	First Health first health facility · percent of total billed charges · bothfrom % of charges	$197	$238	$112	47%	—	$138 – $465
13	Cigna cigna facility · percent of total billed charges · bothfrom % of charges	$209	$253	$119	47%	—	$146 – $494
14	MultiPlan beech street facility · percent of total billed charges · bothfrom % of charges	$222	$268	$126	47%	—	$155 – $523
15	MultiPlan multiplan facility · percent of total billed charges · bothfrom % of charges	$222	$268	$126	47%	—	$155 – $523
16	Phcs multiplan facility · percent of total billed charges · bothfrom % of charges	$222	$268	$126	47%	—	$155 – $523
17	UnitedHealthcare united healthcare facility · percent of total billed charges · bothfrom % of charges	$246	$297	$140	47%	—	$172 – $581

Last updated: Mar 31, 2026

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