Replacement cartridge for laser skin piercing device

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

Replace lensshield cartridge

Payers reporting HCPCS A4257

Payer pricing summary

Low

Average

$21

Median

$19

High

$62

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	Humana fee schedule · outpatient · +8 other terms	299	$18	$28	$29	105%	—	$8 – $140
2	UnitedHealthcare fee schedule · outpatient · +9 other terms	287	$18	$18	$2	14%	—	$8 – $21
3	Aetna fee schedule · outpatient · +7 other terms	274	$18	$21	$12	56%	—	$8 – $109
4	WellCare fee schedule · outpatient · +4 other terms	184	$19	$19	$3	16%	—	$18 – $35
5	Blue Cross Blue Shield fee schedule · outpatient · +6 other terms	178	$19	$22	$9	40%	—	$0 – $62
6	Devoted fee schedule · outpatient · +2 other terms	163	$18	$18	$0	2%	—	$17 – $19
7	Cigna Healthspring fee schedule · outpatient · +1 other terms	116	$19	$19	$0	3%	—	$18 – $20
8	Molina fee schedule · outpatient · +4 other terms	95	$26	$25	$10	39%	—	$15 – $48
9	Cigna fee schedule · outpatient · +5 other terms	86	$19	$20	$7	34%	—	$6 – $53
10	Anthem fee schedule · outpatient · +6 other terms	73	$18	$18	$1	8%	—	$17 – $30
11	Superior Healthplan fee schedule · outpatient	40	$19	$19	$0	0%	—	$18 – $19
12	Kaiser fee schedule · outpatient · +4 other terms	39	$18	$18	$0	2%	—	$17 – $19
13	Clover fee schedule · outpatient · +1 other terms	37	$18	$18	$1	3%	—	$18 – $19
14	Bcbs Tx fee schedule · outpatient	31	$17	$17	$5	29%	—	$13 – $62
15	Optum fee schedule · outpatient · +1 other terms	25	$18	$21	$9	42%	—	$17 – $45
16	Oscar fee schedule · outpatient · +2 other terms	24	$18	$18	$1	3%	—	$18 – $19
17	Caresource facility · case rate · outpatient · +4 other terms	20	$11	$16	$9	58%	—	$7 – $36
18	Medicare fee schedule · outpatient	18	$17	$18	$0	1%	—	$17 – $18
19	Amerihealth Caritas fee schedule · outpatient	16	$22	$22	$0	2%	—	$21 – $22
20	Wellmark fee schedule · both · +1 other terms	13	$18	$18	$1	4%	—	$13 – $18
21	Aetna Better Health fee schedule · outpatient · +2 other terms	12	$9	$12	$5	37%	—	$9 – $18
22	Ambetter case rate · outpatient · +5 other terms	12	$26	$27	$1	4%	—	$26 – $29
23	Bcbs Mn fee schedule · outpatient · +4 other terms	12	$16	$16	$4	26%	—	$8 – $19
24	Bcbs Nj fee schedule · outpatient	12	$18	$38	$26	68%	—	$18 – $79
25	Highmark fee schedule · outpatient · +4 other terms	10	$19	$19	$7	36%	—	$8 – $43

Page 1 of 2 · 50 payers