Reusable rubber pessary

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 Pessary Ring Support/Fold Sz 7

Payers reporting HCPCS A4561

Payer pricing summary

Low

$19

Average

$843

Median

$52

High

$13.5k

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +24 other terms	321	$29	$27	$6	23%	—	$9 – $50
2	Humana fee schedule · outpatient · +22 other terms	309	$29	$44	$46	106%	—	$13 – $226
3	Aetna fee schedule · outpatient · +21 other terms	286	$29	$31	$15	48%	—	$10 – $172
4	Blue Cross Blue Shield fee schedule · outpatient · +19 other terms	196	$30	$39	$17	44%	—	$1 – $112
5	WellCare fee schedule · outpatient · +10 other terms	191	$30	$31	$5	16%	—	$11 – $55
6	Devoted fee schedule · outpatient · +7 other terms	163	$29	$29	$1	2%	—	$28 – $35
7	Cigna Healthspring fee schedule · outpatient · +2 other terms	121	$30	$30	$1	3%	—	$29 – $36
8	Molina fee schedule · outpatient · +18 other terms	107	$34	$39	$15	39%	—	$17 – $77
9	Cigna fee schedule · outpatient · +20 other terms	85	$30	$34	$26	76%	—	$14 – $292
10	Anthem fee schedule · outpatient · +19 other terms	75	$29	$30	$5	16%	—	$11 – $47
11	Kaiser fee schedule · outpatient · +13 other terms	42	$29	$30	$3	9%	—	$28 – $38
12	Superior Healthplan fee schedule · outpatient · +1 other terms	40	$31	$31	$0	0%	—	$29 – $31
13	Clover fee schedule · outpatient · +4 other terms	37	$29	$29	$2	5%	—	$28 – $35
14	Optum fee schedule · outpatient · +11 other terms	31	$29	$33	$13	39%	—	$26 – $73
15	Oscar fee schedule · outpatient · +11 other terms	25	$29	$30	$1	4%	—	$29 – $32
16	Caresource facility · case rate · outpatient · +10 other terms	20	$11	$23	$21	92%	—	$7 – $69
17	Bcbs Tx fee schedule · outpatient	18	$29	$29	—	—	—	$29 – $29
18	Medicare fee schedule · outpatient · +5 other terms	18	$28	$28	$0	1%	—	$28 – $29
19	Amerihealth Caritas fee schedule · outpatient · +5 other terms	16	$35	$35	$1	2%	—	$33 – $35
20	Aetna Better Health fee schedule · outpatient · +7 other terms	13	$14	$69	$107	155%	—	$14 – $352
21	Highmark fee schedule · outpatient · +14 other terms	13	$29	$30	$11	36%	—	$13 – $67
22	Wellmark fee schedule · both · +11 other terms	13	$26	$25	$1	3%	—	$21 – $26
23	Ambetter case rate · outpatient · +11 other terms	12	$42	$43	$4	8%	—	$42 – $54
24	Bcbs Mn fee schedule · outpatient · +4 other terms	12	$25	$16	$14	84%	—	$0 – $31
25	Bcbs Nj fee schedule · outpatient · +3 other terms	12	$28	$60	$41	68%	—	$28 – $123

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