Surgical adhesion barrier film, small incision at University Hospitals Health System

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

MEMBRANE, SEPRAFILM, 3 X 5 IN; 6/PK

Elyria, OH

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How this price compares nationally

University Hospitals Health System’s median price of $516 is 39% below the median hospital's median price ($845), higher than 27% of the 1,293 hospitals reporting HCPCS C1765. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS C1765 at University Hospitals Health System

Negotiated rates from the hospital’s own file: 7 payers, 26 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	UnitedHealthcare commercial facility · percent of total billed charges · inpatientfrom % of charges	$336	$388	$303	78%	—	$18 – $861
2	UnitedHealthcare nexus commercial facility · percent of total billed charges · inpatientfrom % of charges	$339	$391	$305	78%	—	$18 – $869
3	Anthem commercial facility · percent of total billed charges · inpatientfrom % of charges	$356	$411	$321	78%	—	$19 – $913
4	Anthem commercial facility · percent of total billed charges · outpatientfrom % of charges	$356	$411	$321	78%	—	$19 – $913
5	Anthem traditional commercial facility · percent of total billed charges · inpatientfrom % of charges	$356	$411	$321	78%	—	$19 – $913
6	Anthem traditional commercial facility · percent of total billed charges · outpatientfrom % of charges	$356	$411	$321	78%	—	$19 – $913
7	Medical Mutual medflex commercial facility · percent of total billed charges · inpatientfrom % of charges	$356	$411	$321	78%	—	$19 – $913
8	Medical Mutual medflex commercial facility · percent of total billed charges · outpatientfrom % of charges	$356	$411	$321	78%	—	$19 – $913
9	Medical Mutual nas commercial facility · percent of total billed charges · inpatientfrom % of charges	$356	$411	$321	78%	—	$19 – $913
10	Medical Mutual nas commercial facility · percent of total billed charges · outpatientfrom % of charges	$356	$411	$321	78%	—	$19 – $913
11	Medical Mutual supermed hmo facility · percent of total billed charges · inpatientfrom % of charges	$356	$411	$321	78%	—	$19 – $913
12	Medical Mutual supermed hmo facility · percent of total billed charges · outpatientfrom % of charges	$356	$411	$321	78%	—	$19 – $913
13	Medical Mutual northern ohio commercial facility · percent of total billed charges · outpatientfrom % of charges	$364	$420	$328	78%	—	$19 – $934
14	Medical Mutual supermed ppo facility · percent of total billed charges · outpatientfrom % of charges	$369	$426	$333	78%	—	$20 – $947
15	Aetna commercial facility · percent of total billed charges · inpatientfrom % of charges	$377	$435	$339	78%	—	$20 – $965
16	Aetna commercial facility · percent of total billed charges · outpatientfrom % of charges	$377	$435	$339	78%	—	$20 – $965
17	Medical Mutual northern ohio commercial facility · percent of total billed charges · inpatientfrom % of charges	$504	$581	$454	78%	—	$27 – $1.3k
18	Cigna oap commercial facility · percent of total billed charges · inpatientfrom % of charges	$529	$611	$477	78%	—	$28 – $1.4k
19	Cigna ppo commercial facility · percent of total billed charges · inpatientfrom % of charges	$565	$652	$509	78%	—	$30 – $1.4k
20	Cigna ppo commercial facility · percent of total billed charges · outpatientfrom % of charges	$565	$652	$509	78%	—	$30 – $1.4k
21	Medical Mutual hmo facility · percent of total billed charges · inpatientfrom % of charges	$712	$822	$642	78%	—	$38 – $1.8k
22	Medical Mutual hmo facility · percent of total billed charges · outpatientfrom % of charges	$712	$822	$642	78%	—	$38 – $1.8k
23	First Health commercial facility · percent of total billed charges · inpatientfrom % of charges	$845	$975	$761	78%	—	$45 – $2.2k
24	First Health commercial facility · percent of total billed charges · outpatientfrom % of charges	$845	$975	$761	78%	—	$45 – $2.2k
25	MultiPlan commercial facility · percent of total billed charges · inpatientfrom % of charges	$916	$1.1k	$826	78%	—	$49 – $2.3k

Page 1 of 2 · 26 rates

Last updated: Jul 14, 2026

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