Wheelchair with detachable arms and swing-away legrests

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

Wheelchair amputee w/ leg re

Payers reporting HCPCS E1190

Payer pricing summary

Low

Average

$558

Median

$296

High

$5.7k

Payer rate distribution

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#
1	Humana fee schedule · outpatient · +6 other terms	247	$155	$257	$291	113%	—	$113 – $1.3k
2	Aetna fee schedule · outpatient · +5 other terms	236	$164	$327	$866	265%	—	$52 – $9.8k
3	UnitedHealthcare fee schedule · outpatient · +8 other terms	232	$164	$291	$297	102%	—	$69 – $1.4k
4	Blue Cross Blue Shield fee schedule · outpatient · +5 other terms	178	$169	$373	$759	204%	—	$0 – $5.8k
5	WellCare fee schedule · outpatient · +1 other terms	169	$170	$171	$28	17%	—	$142 – $303
6	Devoted fee schedule · outpatient · +1 other terms	151	$167	$161	$12	7%	—	$136 – $177
7	Cigna Healthspring fee schedule · outpatient	104	$152	$163	$9	5%	—	$142 – $174
8	Molina fee schedule · outpatient · +3 other terms	89	$246	$227	$91	40%	—	$123 – $437
9	Cigna fee schedule · outpatient · +3 other terms	69	$168	$271	$634	234%	—	$136 – $4.9k
10	Superior Healthplan fee schedule · outpatient	39	$175	$175	—	—	—	$175 – $175
11	Anthem fee schedule · outpatient · +5 other terms	34	$142	$150	$20	13%	—	$136 – $240
12	Clover fee schedule · outpatient	32	$152	$156	$10	7%	—	$147 – $175
13	Bcbs Tx fee schedule · outpatient	31	$154	$157	$46	29%	—	$116 – $571
14	Kaiser fee schedule · outpatient · +3 other terms	24	$145	$141	$4	3%	—	$136 – $145
15	Optum fee schedule · outpatient · +1 other terms	24	$167	$186	$87	47%	—	$136 – $417
16	Oscar fee schedule · outpatient	24	$164	$157	$7	5%	—	$149 – $164
17	Amerihealth Caritas fee schedule · outpatient	16	$170	$169	$3	2%	—	$162 – $170
18	Caresource fee schedule · outpatient · +3 other terms	15	$142	$142	—	—	—	$142 – $142
19	Medicare fee schedule · outpatient	15	$136	$139	$3	2%	—	$136 – $142
20	Wellmark fee schedule · both · +1 other terms	13	$147	$183	$223	122%	—	$120 – $1.6k
21	Bcbs Mn fee schedule · outpatient · +3 other terms	12	$1.5k	$1.6k	$403	26%	—	$775 – $1.9k
22	Bcbs Nj fee schedule · outpatient	12	$152	$329	$223	68%	—	$152 – $674
23	Highmark fee schedule · outpatient · +3 other terms	10	$360	$364	$424	117%	—	$67 – $1.2k
24	Medica fee schedule · outpatient · +4 other terms	10	$2.2k	$2.1k	$694	34%	—	$262 – $2.8k
25	Medical Mutual fee schedule · outpatient	9	$261	$261	—	—	—	$261 – $261

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