Custom heavy-weight compression arm sleeve

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

Custom grad cm sleeve heavy

Payers reporting HCPCS A6577

Payer pricing summary

Low

$69

Average

$272

Median

$170

High

$1.4k

Payer rate distribution

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#
1	Aetna fee schedule · outpatient · +9 other terms	343	$162	$181	$84	46%	—	$92 – $1.1k
2	UnitedHealthcare fee schedule · outpatient · +11 other terms	335	$163	$163	$34	21%	—	$95 – $536
3	Humana fee schedule · outpatient · +8 other terms	311	$160	$169	$56	33%	—	$75 – $646
4	WellCare fee schedule · outpatient · +4 other terms	215	$166	$170	$25	15%	—	$155 – $313
5	Blue Cross Blue Shield fee schedule · outpatient · +9 other terms	196	$165	$199	$77	39%	—	$0 – $756
6	Devoted fee schedule · outpatient · +2 other terms	163	$162	$162	$3	2%	—	$157 – $173
7	Molina fee schedule · outpatient · +4 other terms	133	$238	$224	$84	37%	—	$121 – $423
8	Cigna Healthspring fee schedule · outpatient · +2 other terms	113	$165	$164	$4	3%	—	$162 – $174
9	Cigna fee schedule · outpatient · +6 other terms	95	$166	$185	$53	28%	—	$157 – $467
10	Anthem fee schedule · outpatient · +6 other terms	73	$158	$224	$223	99%	—	$157 – $1.2k
11	Kaiser fee schedule · outpatient · +4 other terms	61	$165	$231	$168	73%	—	$157 – $1.2k
12	Ambetter facility · fee schedule · outpatient · +5 other terms	41	$269	$291	$73	25%	—	$112 – $401
13	Clover fee schedule · outpatient · +2 other terms	41	$167	$165	$4	3%	—	$157 – $170
14	Superior Healthplan fee schedule · outpatient	40	$170	$170	$1	1%	—	$157 – $170
15	Caresource fee schedule · outpatient · +7 other terms	36	$163	$178	$31	18%	—	$160 – $250
16	Oscar fee schedule · outpatient · +4 other terms	35	$170	$185	$39	21%	—	$158 – $275
17	Optum fee schedule · outpatient · +2 other terms	33	$162	$212	$85	40%	—	$155 – $404
18	Bcbs Tx fee schedule · outpatient	31	$168	$174	$52	30%	—	$130 – $641
19	Medicare fee schedule · outpatient · +1 other terms	23	$158	$159	$0	0%	—	$158 – $159
20	Amerihealth Caritas fee schedule · outpatient · +1 other terms	18	$194	$189	$9	5%	—	$165 – $194
21	Regence facility · fee schedule · outpatient · +1 other terms	18	$168	$164	$10	6%	—	$134 – $171
22	Medical Mutual facility · fee schedule · outpatient · +1 other terms	14	$162	$186	$47	25%	—	$88 – $255
23	Bcbs Mn fee schedule · outpatient · +4 other terms	13	$161	$154	$7	5%	—	$145 – $161
24	Wellmark fee schedule · both · +1 other terms	13	$142	$141	$1	0%	—	$137 – $142
25	Aetna Better Health fee schedule · outpatient · +3 other terms	12	$77	$110	$40	36%	—	$77 – $157

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