Activated carbon filter, each

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

Activated carbon filter, ea

Payers reporting HCPCS A4680

Payer pricing summary

Low

Average

$130

Median

$49

High

$1.1k

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	Humana fee schedule · outpatient · +5 other terms	71	$148	$237	$153	65%	—	$20 – $434
2	Blue Cross Blue Shield facility · fee schedule · outpatient · +5 other terms	35	$49	$164	$211	129%	—	$0 – $949
3	Aetna fee schedule · outpatient · +7 other terms	29	$47	$63	$58	93%	—	$23 – $316
4	UnitedHealthcare fee schedule · both · +7 other terms	26	$26	$50	$31	62%	—	$26 – $123
5	Anthem facility · case rate · outpatient · +6 other terms	15	$15	$17	$4	23%	—	$10 – $26
6	Caresource facility · case rate · outpatient · +1 other terms	15	$16	$17	$4	23%	—	$10 – $27
7	Cigna fee schedule · both · +5 other terms	15	$103	$93	$20	21%	—	$40 – $103
8	Molina facility · case rate · outpatient · +3 other terms	15	$15	$17	$4	23%	—	$11 – $26
9	Wellmark fee schedule · both · +1 other terms	13	$75	$74	$9	12%	—	$18 – $75
10	Optum facility · case rate · outpatient · +2 other terms	11	$14	$16	$4	22%	—	$13 – $24
11	Highmark fee schedule · outpatient · +2 other terms	10	$83	$83	—	—	—	$83 – $83
12	Medica fee schedule · outpatient · +4 other terms	10	$90	$90	$23	26%	—	$54 – $116
13	Ucare fee schedule · both	9	$2	$2	$0	5%	—	$2 – $2
14	Bcbs Mn fee schedule · both · +2 other terms	8	$2	$2	—	—	—	$2 – $2
15	Aetna Better Health fee schedule · inpatient · +1 other terms	7	$21	$21	—	—	—	$21 – $21
16	Bcbs Ks fee schedule · outpatient · +1 other terms	3	$55	$58	$3	6%	—	$55 – $62
17	First Health professional · fee schedule · both · +2 other terms	3	$27	$27	—	—	—	$27 – $27
18	Kaiser fee schedule · both	2	$182	$182	—	—	—	$182 – $182
19	Bcbs Id facility · fee schedule · outpatient · +1 other terms	1	$74	$74	—	—	—	$74 – $74
20	Bcbs Il professional · fee schedule · both	1	$18	$18	—	—	—	$18 – $18
21	Bcbs La facility · fee schedule · outpatient	1	$0	$0	—	—	—	$0 – $0
22	Bcbs Nc facility · fee schedule · outpatient	1	$34	$34	$9	25%	—	$22 – $40
23	Bcbs Nv fee schedule · outpatient	1	$32	$32	—	—	—	$32 – $32
24	Bcbs Vt professional · fee schedule · outpatient	1	$32	$32	—	—	—	$32 – $32
25	Devoted percent of total billed chargesfrom % of charges	1	$15	$15	—	—	—	$15 – $15

Page 1 of 2 · 28 payers