Retina pattern response test with report

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

PATTERN ELECTRORETINOGRAPHY W/I&R

Payers reporting CPT 0509T

Payer pricing summary

Low

$47

Average

$284

Median

$213

High

$933

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	Aetna fee schedule · outpatient · +21 other terms	362	$253	$300	$228	76%	—	$1 – $2.1k
2	Blue Cross Blue Shield fee schedule · outpatient · +20 other terms	292	$222	$394	$1.1k	273%	—	$0 – $13.0k
3	UnitedHealthcare fee schedule · outpatient · +22 other terms	271	$292	$292	$438	150%	—	$1 – $9.2k
4	Humana fee schedule · outpatient · +20 other terms	242	$283	$240	$91	38%	—	$1 – $696
5	Cigna fee schedule · outpatient · +19 other terms	149	$267	$2.1k	$4.3k	205%	—	$30 – $20.1k
6	WellCare fee schedule · outpatient · +12 other terms	116	$293	$312	$138	44%	—	$22 – $730
7	Molina fee schedule · outpatient · +17 other terms	109	$312	$289	$113	39%	—	$1 – $585
8	Anthem fee schedule · outpatient · +14 other terms	91	$292	$159	$258	162%	—	$20 – $1.9k
9	Ambetter facility · fee schedule · outpatient · +12 other terms	75	$459	$492	$182	37%	—	$105 – $797
10	Devoted fee schedule · outpatient · +8 other terms	68	$239	$241	$83	35%	—	$55 – $345
11	Kaiser fee schedule · outpatient · +10 other terms	60	$313	$438	$362	83%	—	$47 – $2.2k
12	Oscar fee schedule · outpatient · +11 other terms	48	$405	$284	$194	68%	—	$1 – $617
13	Optum fee schedule · outpatient · +11 other terms	36	$209	$254	$185	73%	—	$55 – $797
14	Bcbs Tx fee schedule · outpatient · +1 other terms	32	$270	$271	$73	27%	—	$94 – $503
15	Caresource facility · fee schedule · outpatient · +9 other terms	30	$332	$291	$131	45%	—	$19 – $580
16	Clover fee schedule · outpatient · +6 other terms	26	$340	$298	$62	21%	—	$195 – $367
17	Baylor Scott White Health Plan facility · fee schedule · outpatient · +1 other terms	25	$274	$273	$55	20%	—	$206 – $358
18	Regence facility · fee schedule · outpatient · +3 other terms	21	$231	$392	$299	76%	—	$219 – $1.1k
19	Superior Healthplan facility · fee schedule · outpatient · +2 other terms	21	$228	$224	$5	2%	—	$217 – $228
20	Medicare fee schedule · outpatient · +9 other terms	19	$55	$61	$45	74%	—	$47 – $273
21	Highmark fee schedule · outpatient · +5 other terms	16	$144	$139	$150	108%	—	$26 – $760
22	Medical Mutual facility · fee schedule · outpatient · +2 other terms	16	$210	$259	$154	60%	—	$111 – $812
23	First Health fee schedule · outpatient · +8 other terms	15	$225	$259	$73	28%	—	$225 – $440
24	MultiPlan fee schedule · outpatient · +12 other terms	15	$503	$496	$38	8%	—	$292 – $503
25	Bcbs Mn fee schedule · outpatient · +6 other terms	13	$347	$385	$187	49%	—	$139 – $1.1k

Page 1 of 3 · 60 payers