Wheelchair with detachable arms and swing-away leg rests

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

Hemi-wheelchair detachable a

Payers reporting HCPCS E1084

Payer pricing summary

Low

Average

$454

Median

$248

High

$4.0k

Payer rate distribution

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#
1	Humana fee schedule · outpatient · +6 other terms	247	$138	$218	$244	112%	—	$94 – $1.1k
2	Aetna fee schedule · outpatient · +5 other terms	236	$137	$289	$781	270%	—	$44 – $8.9k
3	UnitedHealthcare fee schedule · outpatient · +8 other terms	232	$137	$254	$271	107%	—	$58 – $1.3k
4	Blue Cross Blue Shield fee schedule · outpatient · +5 other terms	178	$139	$310	$630	203%	—	$0 – $4.9k
5	WellCare fee schedule · outpatient · +1 other terms	169	$143	$146	$26	18%	—	$119 – $273
6	Devoted fee schedule · outpatient · +1 other terms	151	$140	$136	$8	6%	—	$119 – $148
7	Cigna Healthspring fee schedule · outpatient	104	$140	$138	$6	4%	—	$119 – $145
8	Molina fee schedule · outpatient · +3 other terms	89	$206	$194	$75	39%	—	$107 – $366
9	Cigna fee schedule · outpatient · +3 other terms	69	$137	$220	$448	204%	—	$125 – $3.5k
10	Superior Healthplan fee schedule · outpatient	39	$147	$147	—	—	—	$147 – $147
11	Anthem fee schedule · outpatient · +5 other terms	34	$140	$141	$13	9%	—	$133 – $217
12	Clover fee schedule · outpatient	32	$141	$142	$5	3%	—	$137 – $147
13	Bcbs Tx fee schedule · outpatient	31	$129	$132	$39	29%	—	$97 – $479
14	Kaiser fee schedule · outpatient · +3 other terms	24	$143	$139	$4	3%	—	$134 – $143
15	Optum fee schedule · outpatient · +1 other terms	24	$134	$157	$71	46%	—	$119 – $350
16	Oscar fee schedule · outpatient	24	$137	$132	$6	5%	—	$125 – $137
17	Amerihealth Caritas fee schedule · outpatient	16	$143	$143	$2	1%	—	$143 – $147
18	Caresource fee schedule · outpatient · +3 other terms	15	$119	$119	—	—	—	$119 – $119
19	Medicare fee schedule · outpatient	15	$134	$129	$6	4%	—	$124 – $137
20	Wellmark fee schedule · both · +1 other terms	13	$123	$153	$187	122%	—	$100 – $1.3k
21	Bcbs Mn fee schedule · outpatient · +3 other terms	12	$1.1k	$1.1k	$287	26%	—	$552 – $1.3k
22	Bcbs Nj fee schedule · outpatient	12	$137	$296	$201	68%	—	$137 – $606
23	Highmark fee schedule · outpatient · +3 other terms	10	$346	$350	$408	117%	—	$64 – $1.1k
24	Medica fee schedule · outpatient · +4 other terms	10	$1.8k	$1.7k	$581	34%	—	$220 – $2.3k
25	Medical Mutual fee schedule · outpatient	9	$251	$251	—	—	—	$251 – $251

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