Ophthalmic lacrimal duct stent for tear drainage

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

TUBE JONES 3MM X 16MM STRAIGHT

Payers reporting HCPCS A4263

Payer pricing summary

Low

$11

Average

$269

Median

$169

High

$3.1k

Payer rate distribution

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#
1	Blue Cross Blue Shield facility · fee schedule · outpatient · +21 other terms	47	$34	$91	$189	207%	—	$0 – $1.1k
2	Humana fee schedule · outpatient · +14 other terms	45	$193	$181	$93	51%	—	$12 – $263
3	UnitedHealthcare fee schedule · both · +17 other terms	39	$16	$36	$55	155%	—	$10 – $336
4	Medcost percent of total billed charges · outpatientfrom % of charges · +6 other terms	23	$126	$189	$208	110%	—	$16 – $1.2k
5	Aetna fee schedule · outpatient · +17 other terms	20	$29	$104	$82	79%	—	$14 – $329
6	Beechstreet percent of total billed charges · outpatientfrom % of charges · +1 other terms	18	$190	$208	$201	96%	—	$79 – $1.6k
7	Cigna fee schedule · both · +17 other terms	16	$62	$86	$86	99%	—	$24 – $336
8	Anthem facility · case rate · outpatient · +14 other terms	15	$10	$11	$3	23%	—	$7 – $17
9	Caresource facility · case rate · outpatient · +9 other terms	15	$10	$11	$3	23%	—	$7 – $17
10	Molina facility · case rate · outpatient · +12 other terms	15	$10	$11	$3	23%	—	$7 – $17
11	Medica fee schedule · outpatient · +12 other terms	13	$53	$55	$15	28%	—	$26 – $84
12	Wellmark fee schedule · both · +2 other terms	13	$75	$76	$12	16%	—	$75 – $150
13	Amerihealth Caritas fee schedule · both · +4 other terms	12	$10	$10	—	—	—	$10 – $10
14	Bcbs Mn fee schedule · outpatient · +5 other terms	12	$141	$80	$79	99%	—	$0 – $176
15	Clover facility · percent of total billed charges · outpatientfrom % of charges · +2 other terms	12	$63	$58	$33	56%	—	$0 – $116
16	Magellan percent of total billed charges · outpatientfrom % of charges · +3 other terms	12	$127	$481	$972	202%	—	$55 – $4.2k
17	Sanford Health Plan percent of total billed charges · outpatientfrom % of charges · +5 other terms	12	$170	$202	$87	43%	—	$74 – $404
18	Ucare percent of total billed charges · outpatientfrom % of charges · +3 other terms	12	$144	$224	$182	81%	—	$87 – $801
19	WellCare fee schedule · both · +6 other terms	12	$10	$10	$0	0%	—	$10 – $10
20	Optum facility · case rate · outpatient · +7 other terms	11	$10	$10	$2	22%	—	$9 – $15
21	Highmark fee schedule · outpatient · +6 other terms	10	$37	$37	—	—	—	$37 – $37
22	Ambetter other · outpatient · +10 other terms	8	$4.4k	$4.4k	$1.6k	36%	—	$1.7k – $6.0k
23	Bcbs Il professional · fee schedule · both	8	$38	$46	$69	151%	—	$0 – $150
24	First Health professional · fee schedule · both · +11 other terms	8	$0	$6	$8	129%	—	$0 – $16
25	Aetna Better Health fee schedule · inpatient · +7 other terms	7	$12	$12	—	—	—	$12 – $12

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