Wheelchair ventilator tray with gimbal mount

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

W/c vent tray gimbaled

Payers reporting HCPCS E1030

Payer pricing summary

Low

$28

Average

$510

Median

$283

High

$4.9k

Payer rate distribution

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#
1	Humana fee schedule · outpatient · +6 other terms	267	$143	$219	$230	105%	—	$107 – $1.1k
2	Aetna fee schedule · outpatient · +5 other terms	259	$145	$287	$739	257%	—	$53 – $9.5k
3	UnitedHealthcare fee schedule · outpatient · +8 other terms	257	$145	$273	$309	113%	—	$70 – $1.5k
4	Blue Cross Blue Shield fee schedule · outpatient · +5 other terms	190	$147	$327	$648	198%	—	$0 – $5.0k
5	WellCare fee schedule · outpatient · +1 other terms	185	$147	$153	$25	16%	—	$140 – $279
6	Devoted fee schedule · outpatient · +1 other terms	165	$143	$144	$4	3%	—	$138 – $162
7	Cigna Healthspring fee schedule · outpatient	111	$149	$146	$4	3%	—	$143 – $155
8	Molina fee schedule · outpatient · +3 other terms	96	$203	$196	$74	38%	—	$119 – $375
9	Cigna fee schedule · outpatient · +3 other terms	77	$147	$220	$422	192%	—	$138 – $4.2k
10	Superior Healthplan fee schedule · outpatient	40	$150	$150	—	—	—	$150 – $150
11	Anthem fee schedule · outpatient · +5 other terms	38	$143	$149	$25	17%	—	$138 – $263
12	Clover fee schedule · outpatient	34	$149	$146	$5	3%	—	$140 – $150
13	Bcbs Tx fee schedule · outpatient	31	$139	$143	$42	29%	—	$106 – $523
14	Optum fee schedule · outpatient · +2 other terms	28	$143	$158	$58	37%	—	$138 – $358
15	Kaiser fee schedule · outpatient · +3 other terms	27	$146	$142	$4	3%	—	$138 – $151
16	Oscar fee schedule · outpatient	24	$140	$144	$5	3%	—	$140 – $150
17	Medicare fee schedule · outpatient	18	$138	$138	$3	2%	—	$138 – $151
18	Amerihealth Caritas fee schedule · outpatient	17	$172	$170	$3	2%	—	$163 – $172
19	Caresource fee schedule · outpatient · +3 other terms	15	$143	$143	—	—	—	$143 – $143
20	Wellmark fee schedule · both · +1 other terms	13	$695	$695	$570	82%	—	$103 – $1.3k
21	Bcbs Mn fee schedule · outpatient · +3 other terms	12	$1.3k	$1.3k	$344	26%	—	$661 – $1.6k
22	Bcbs Nj fee schedule · outpatient	12	$140	$303	$205	68%	—	$140 – $621
23	MultiPlan facility · fee schedule · outpatient · +2 other terms	11	$421	$416	$17	4%	—	$363 – $421
24	Highmark fee schedule · outpatient · +3 other terms	10	$274	$278	$320	115%	—	$66 – $1.2k
25	Medica fee schedule · outpatient · +4 other terms	10	$2.2k	$2.1k	$698	34%	—	$225 – $2.8k

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