Quantitative acid mucopolysaccharide test

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

HC MUCOPOLYSACCHARIDES ACID QUANTITATIVE

Payers reporting CPT 83864

Payer pricing summary

Low

$14

Average

$130

Median

$82

High

$638

Payer rate distribution

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#
1	Anthem fee schedule · outpatient · +20 other terms	191	$33	$50	$55	110%	4–40	$4 – $392
2	Molina fee schedule · outpatient · +24 other terms	284	$31	$34	$19	56%	2–20	$1 – $266
3	UnitedHealthcare fee schedule · outpatient · +29 other terms	727	$29	$31	$21	67%	1–10	$1 – $432
4	Aetna fee schedule · outpatient · +24 other terms	687	$32	$85	$382	449%	—	$0 – $8.4k
5	Humana fee schedule · outpatient · +23 other terms	496	$29	$56	$62	110%	—	$1 – $308
6	Cigna fee schedule · outpatient · +23 other terms	483	$54	$67	$53	79%	—	$5 – $569
7	Blue Cross Blue Shield fee schedule · outpatient · +27 other terms	454	$40	$61	$50	83%	—	$1 – $450
8	WellCare fee schedule · outpatient · +14 other terms	298	$29	$30	$6	20%	—	$15 – $103
9	Devoted fee schedule · outpatient · +11 other terms	197	$29	$29	$1	4%	—	$19 – $33
10	Oscar fee schedule · outpatient · +17 other terms	163	$55	$61	$21	34%	—	$20 – $87
11	Cigna Healthspring fee schedule · outpatient · +8 other terms	133	$30	$29	$2	8%	—	$24 – $49
12	Ambetter fee schedule · outpatient · +15 other terms	110	$46	$39	$14	35%	—	$12 – $77
13	Aetna Better Health fee schedule · outpatient · +18 other terms	96	$26	$26	$2	8%	—	$16 – $30
14	Kaiser fee schedule · outpatient · +16 other terms	94	$29	$42	$37	87%	—	$5 – $255
15	Caresource fee schedule · outpatient · +15 other terms	69	$29	$31	$19	62%	—	$1 – $227
16	Optum fee schedule · outpatient · +18 other terms	62	$29	$35	$14	39%	—	$28 – $82
17	Superior Healthplan fee schedule · outpatient · +5 other terms	53	$30	$171	$202	118%	—	$24 – $479
18	Amerihealth Caritas fee schedule · outpatient · +11 other terms	51	$29	$30	$8	26%	—	$4 – $43
19	Tricare fee schedule · outpatient · +13 other terms	45	$29	$28	$2	7%	—	$19 – $33
20	First Health fee schedule · outpatient · +15 other terms	44	$29	$57	$80	139%	—	$24 – $502
21	Clover fee schedule · outpatient · +7 other terms	43	$29	$29	$1	2%	—	$29 – $30
22	Highmark facility · fee schedule · outpatient · +14 other terms	37	$32	$76	$69	92%	—	$19 – $276
23	MultiPlan fee schedule · outpatient · +15 other terms	34	$79	$95	$97	102%	—	$19 – $410
24	Bcbs Tx fee schedule · outpatient · +2 other terms	32	$104	$110	$53	48%	—	$29 – $245
25	Medicare fee schedule · both · +9 other terms	31	$29	$29	—	—	—	$29 – $29

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