Monthly supplies for a medical 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

Monthly supp use with e0733

Payers reporting HCPCS A4541

Payer pricing summary

Low

$18

Average

$49

Median

$43

High

$140

Payer rate distribution

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#
1	Humana fee schedule · outpatient · +7 other terms	296	$41	$43	$15	35%	—	$19 – $164
2	UnitedHealthcare fee schedule · outpatient · +9 other terms	291	$41	$40	$4	11%	—	$24 – $55
3	Aetna fee schedule · outpatient · +6 other terms	277	$41	$45	$21	48%	—	$24 – $248
4	WellCare fee schedule · outpatient · +4 other terms	190	$42	$44	$7	16%	—	$40 – $80
5	Devoted fee schedule · outpatient · +2 other terms	163	$41	$41	$1	2%	—	$40 – $43
6	Blue Cross Blue Shield fee schedule · outpatient · +6 other terms	156	$42	$51	$17	32%	—	$0 – $162
7	Cigna Healthspring fee schedule · outpatient · +1 other terms	116	$42	$42	$1	3%	—	$41 – $44
8	Molina fee schedule · outpatient · +4 other terms	95	$60	$57	$22	39%	—	$40 – $108
9	Cigna fee schedule · outpatient · +5 other terms	85	$42	$47	$14	29%	—	$40 – $120
10	Anthem fee schedule · outpatient · +6 other terms	73	$40	$41	$3	8%	—	$40 – $66
11	Superior Healthplan fee schedule · outpatient	40	$43	$43	$0	0%	—	$40 – $43
12	Kaiser fee schedule · outpatient · +3 other terms	39	$40	$41	$1	2%	—	$40 – $42
13	Clover fee schedule · outpatient · +1 other terms	37	$41	$42	$1	3%	—	$40 – $43
14	Bcbs Tx fee schedule · outpatient	31	$43	$45	$13	30%	—	$33 – $165
15	Optum fee schedule · outpatient · +1 other terms	25	$41	$48	$20	41%	—	$40 – $103
16	Caresource fee schedule · outpatient · +4 other terms	24	$41	$46	$9	19%	—	$41 – $62
17	Oscar fee schedule · outpatient · +2 other terms	24	$40	$41	$1	3%	—	$40 – $43
18	Medicare fee schedule · outpatient	18	$40	$40	—	—	—	$40 – $40
19	Amerihealth Caritas fee schedule · outpatient · +1 other terms	16	$49	$49	$1	2%	—	$47 – $49
20	Ambetter fee schedule · outpatient · +5 other terms	14	$74	$75	$8	11%	—	$61 – $84
21	Wellmark fee schedule · both · +1 other terms	13	$36	$35	$1	3%	—	$29 – $36
22	Aetna Better Health fee schedule · outpatient · +2 other terms	12	$20	$28	$10	35%	—	$20 – $40
23	Bcbs Nj fee schedule · outpatient	12	$40	$87	$59	68%	—	$40 – $178
24	Highmark fee schedule · outpatient · +4 other terms	10	$42	$44	$16	36%	—	$19 – $97
25	Medica fee schedule · outpatient · +4 other terms	10	$80	$80	$20	25%	—	$48 – $103

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