Heavy-duty wheelchair with swing-away elevating 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 heavy dut

Payers reporting HCPCS E1195

Payer pricing summary

Low

Average

$573

Median

$307

High

$5.2k

Payer rate distribution

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#
1	Humana fee schedule · outpatient · +6 other terms	247	$176	$275	$311	113%	—	$119 – $1.4k
2	Aetna fee schedule · outpatient · +5 other terms	236	$176	$374	$1.1k	298%	—	$56 – $13.0k
3	UnitedHealthcare fee schedule · outpatient · +8 other terms	232	$176	$311	$314	101%	—	$74 – $1.4k
4	Blue Cross Blue Shield fee schedule · outpatient · +5 other terms	178	$182	$393	$779	198%	—	$0 – $5.8k
5	WellCare fee schedule · outpatient · +1 other terms	169	$184	$184	$25	14%	—	$149 – $297
6	Devoted fee schedule · outpatient · +1 other terms	151	$179	$175	$11	6%	—	$152 – $190
7	Cigna Healthspring fee schedule · outpatient	104	$165	$175	$7	4%	—	$152 – $183
8	Molina fee schedule · outpatient · +3 other terms	89	$264	$245	$99	40%	—	$127 – $469
9	Cigna fee schedule · outpatient · +3 other terms	69	$181	$277	$574	208%	—	$157 – $4.5k
10	Superior Healthplan fee schedule · outpatient	39	$188	$188	—	—	—	$188 – $188
11	Anthem fee schedule · outpatient · +5 other terms	34	$179	$178	$20	11%	—	$163 – $292
12	Clover fee schedule · outpatient	32	$154	$161	$15	9%	—	$149 – $188
13	Bcbs Tx fee schedule · outpatient	31	$165	$169	$50	29%	—	$124 – $613
14	Kaiser fee schedule · outpatient · +3 other terms	24	$183	$178	$5	3%	—	$172 – $183
15	Optum fee schedule · outpatient · +1 other terms	24	$176	$206	$89	43%	—	$159 – $448
16	Oscar fee schedule · outpatient	24	$175	$169	$8	5%	—	$160 – $175
17	Amerihealth Caritas fee schedule · outpatient · +1 other terms	16	$183	$181	$4	2%	—	$173 – $183
18	Caresource fee schedule · outpatient · +3 other terms	15	$152	$152	—	—	—	$152 – $152
19	Medicare fee schedule · outpatient	15	$172	$160	$13	8%	—	$146 – $176
20	Wellmark fee schedule · both · +1 other terms	13	$157	$188	$200	106%	—	$109 – $1.4k
21	Bcbs Mn fee schedule · outpatient · +3 other terms	12	$1.4k	$1.4k	$367	26%	—	$707 – $1.7k
22	Bcbs Nj fee schedule · outpatient	12	$149	$322	$218	68%	—	$149 – $660
23	Highmark fee schedule · outpatient · +3 other terms	10	$377	$381	$444	117%	—	$70 – $1.2k
24	Medica fee schedule · outpatient · +4 other terms	10	$2.3k	$2.2k	$744	34%	—	$282 – $3.0k
25	Medical Mutual fee schedule · outpatient	9	$273	$273	—	—	—	$273 – $273

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