Mass spectrometry analysis of a sample

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

Urine Hexose Tetrasaccharide

Payers reporting CPT 83789

Payer pricing summary

Low

$13

Average

$275

Median

$95

High

$3.6k

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	UnitedHealthcare fee schedule · outpatient · +34 other terms	826	$24	$33	$50	149%	39–390	$1 – $1.4k
2	Molina fee schedule · outpatient · +30 other terms	309	$27	$30	$17	56%	31–40	$1 – $226
3	Bcbs Al facility · other · outpatient · +3 other terms	4	$17	$19	$2	11%	16–25	$16 – $21
4	Anthem fee schedule · outpatient · +24 other terms	248	$27	$39	$36	94%	14–140	$4 – $289
5	Healthpartners fee schedule · outpatient · +11 other terms	27	$73	$69	$13	18%	5–50	$25 – $82
6	Aetna fee schedule · outpatient · +32 other terms	756	$30	$73	$266	365%	4–40	$0 – $8.4k
7	Caresource fee schedule · outpatient · +16 other terms	103	$24	$30	$25	86%	4–40	$1 – $231
8	Aetna Better Health fee schedule · outpatient · +18 other terms	108	$22	$23	$3	13%	3–30	$8 – $26
9	Bcbs Mt fee schedule · outpatient · +2 other terms	1	$40	$40	$16	39%	2–20	$24 – $55
10	Blue Cross Blue Shield fee schedule · outpatient · +34 other terms	551	$37	$61	$60	99%	1–10	$1 – $509
11	Humana fee schedule · outpatient · +27 other terms	548	$24	$43	$59	138%	—	$1 – $1.4k
12	Cigna fee schedule · outpatient · +25 other terms	519	$47	$56	$68	122%	—	$5 – $2.6k
13	WellCare fee schedule · outpatient · +20 other terms	304	$25	$26	$11	43%	—	$8 – $214
14	Devoted fee schedule · outpatient · +15 other terms	184	$24	$24	$1	2%	—	$24 – $28
15	Oscar fee schedule · outpatient · +18 other terms	165	$47	$51	$17	34%	—	$24 – $74
16	Cigna Healthspring fee schedule · outpatient · +8 other terms	137	$25	$25	$3	14%	—	$14 – $41
17	Kaiser fee schedule · outpatient · +20 other terms	129	$25	$30	$29	98%	—	$3 – $601
18	Ambetter facility · fee schedule · outpatient · +20 other terms	118	$42	$41	$10	25%	—	$24 – $61
19	Tricare facility · fee schedule · outpatient · +16 other terms	106	$23	$30	$27	92%	—	$6 – $151
20	MultiPlan fee schedule · outpatient · +20 other terms	103	$110	$154	$257	167%	—	$12 – $3.7k
21	First Health fee schedule · outpatient · +17 other terms	64	$38	$86	$208	242%	—	$10 – $3.3k
22	Optum fee schedule · outpatient · +21 other terms	64	$24	$55	$159	288%	—	$15 – $2.2k
23	Medicaid facility · fee schedule · outpatient · +14 other terms	62	$23	$23	$3	13%	—	$16 – $33
24	Medicare fee schedule · both · +14 other terms	62	$24	$24	$2	7%	—	$24 – $33
25	Highmark facility · fee schedule · outpatient · +18 other terms	59	$41	$80	$63	79%	—	$16 – $244

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