Replacement cushion for oral-nasal CPAP mask

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

Repl oral cushion combo mask

Payers reporting HCPCS A7028

Payer pricing summary

Low

Average

$54

Median

$49

High

$114

Payer rate distribution

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#
1	Humana fee schedule · outpatient · +8 other terms	267	$43	$64	$63	99%	—	$23 – $311
2	Aetna fee schedule · outpatient · +6 other terms	259	$43	$53	$35	66%	—	$22 – $351
3	UnitedHealthcare fee schedule · outpatient · +10 other terms	257	$42	$44	$10	24%	—	$23 – $72
4	Blue Cross Blue Shield fee schedule · outpatient · +5 other terms	191	$50	$60	$27	45%	—	$0 – $227
5	WellCare fee schedule · outpatient · +2 other terms	185	$43	$45	$8	18%	—	$39 – $78
6	Devoted fee schedule · outpatient · +1 other terms	165	$43	$43	$6	13%	—	$40 – $66
7	Cigna Healthspring fee schedule · outpatient	111	$45	$43	$4	10%	—	$41 – $63
8	Molina fee schedule · outpatient · +5 other terms	96	$60	$58	$22	38%	—	$34 – $154
9	Cigna fee schedule · outpatient · +7 other terms	77	$44	$56	$19	35%	—	$40 – $126
10	Superior Healthplan fee schedule · outpatient	40	$43	$43	$3	7%	—	$43 – $62
11	Anthem fee schedule · outpatient · +7 other terms	38	$42	$47	$15	31%	—	$40 – $107
12	Clover fee schedule · outpatient	34	$43	$43	$6	14%	—	$39 – $62
13	Bcbs Tx fee schedule · outpatient	31	$51	$53	$17	31%	—	$40 – $199
14	Optum fee schedule · outpatient · +2 other terms	28	$43	$51	$19	37%	—	$40 – $102
15	Kaiser fee schedule · outpatient · +2 other terms	27	$42	$43	$5	11%	—	$40 – $57
16	Oscar fee schedule · outpatient	24	$40	$42	$3	6%	—	$40 – $45
17	Medicare fee schedule · outpatient	18	$40	$42	$6	14%	—	$40 – $57
18	Amerihealth Caritas fee schedule · outpatient · +1 other terms	17	$52	$53	$6	11%	—	$49 – $70
19	Caresource fee schedule · outpatient · +3 other terms	15	$43	$43	—	—	—	$43 – $43
20	Wellmark fee schedule · both · +1 other terms	13	$62	$60	$6	10%	—	$36 – $62
21	Bcbs Mn fee schedule · outpatient · +3 other terms	12	$40	$41	$11	26%	—	$21 – $50
22	Bcbs Nj fee schedule · outpatient	12	$39	$85	$57	68%	—	$39 – $174
23	MultiPlan facility · fee schedule · outpatient · +6 other terms	11	$172	$167	$15	9%	—	$121 – $172
24	Highmark fee schedule · outpatient · +3 other terms	10	$53	$55	$22	40%	—	$18 – $137
25	Medica fee schedule · outpatient · +8 other terms	10	$83	$84	$21	25%	—	$51 – $108

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