Irrigation tray with syringe

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

DAVOL 70CC IRRIGATING SYR

Payers reporting HCPCS A4320

Payer pricing summary

Low

Average

Median

High

$26

Payer rate distribution

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#
1	Humana fee schedule · outpatient · +12 other terms	302	$7	$10	$10	99%	—	$1 – $50
2	UnitedHealthcare fee schedule · outpatient · +15 other terms	292	$7	$7	$1	17%	—	$2 – $8
3	Aetna fee schedule · outpatient · +15 other terms	267	$7	$8	$4	46%	—	$3 – $38
4	Blue Cross Blue Shield fee schedule · outpatient · +13 other terms	187	$8	$8	$4	48%	—	$0 – $32
5	WellCare fee schedule · outpatient · +5 other terms	185	$7	$7	$1	19%	—	$6 – $14
6	Devoted fee schedule · outpatient · +4 other terms	163	$7	$7	$0	7%	—	$6 – $8
7	Cigna Healthspring fee schedule · outpatient · +1 other terms	116	$8	$7	$1	10%	—	$6 – $8
8	Molina fee schedule · outpatient · +6 other terms	97	$10	$9	$3	38%	—	$6 – $17
9	Cigna fee schedule · outpatient · +11 other terms	77	$7	$8	$2	26%	—	$6 – $17
10	Anthem fee schedule · outpatient · +9 other terms	74	$7	$8	$1	7%	—	$6 – $11
11	Superior Healthplan fee schedule · outpatient	41	$7	$7	$1	13%	—	$6 – $18
12	Kaiser fee schedule · outpatient · +4 other terms	39	$7	$7	$0	2%	—	$7 – $8
13	Clover fee schedule · outpatient · +1 other terms	37	$7	$7	$0	6%	—	$7 – $8
14	Bcbs Tx fee schedule · outpatient · +3 other terms	31	$6	$6	$2	30%	—	$4 – $22
15	Optum fee schedule · outpatient · +2 other terms	25	$7	$8	$3	37%	—	$6 – $16
16	Oscar fee schedule · outpatient · +2 other terms	24	$6	$7	$1	12%	—	$6 – $8
17	Caresource facility · case rate · outpatient · +5 other terms	20	$15	$15	$4	28%	—	$7 – $27
18	Medicare fee schedule · outpatient · +1 other terms	18	$7	$7	$0	2%	—	$7 – $7
19	Amerihealth Caritas fee schedule · outpatient · +2 other terms	16	$9	$9	$1	8%	—	$7 – $9
20	Aetna Better Health fee schedule · outpatient · +4 other terms	13	$3	$5	$2	38%	—	$3 – $8
21	Wellmark fee schedule · both · +1 other terms	13	$6	$6	$0	2%	—	$5 – $6
22	Ambetter case rate · outpatient · +5 other terms	12	$10	$10	$1	6%	—	$10 – $12
23	Bcbs Mn fee schedule · outpatient · +4 other terms	12	$6	$4	$3	76%	—	$0 – $8
24	Bcbs Nj fee schedule · outpatient	12	$7	$15	$10	68%	—	$7 – $31
25	Medica fee schedule · outpatient · +5 other terms	12	$14	$14	$5	37%	—	$1 – $19

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