Wheelchair with fixed arms and footrests

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 spec size w foot

Payers reporting HCPCS E1221

Payer pricing summary

Low

Average

$217

Median

$116

High

$2.0k

Payer rate distribution

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#
1	Humana fee schedule · outpatient · +6 other terms	247	$65	$104	$118	113%	—	$46 – $521
2	Aetna fee schedule · outpatient · +5 other terms	236	$66	$139	$394	283%	—	$21 – $4.5k
3	UnitedHealthcare fee schedule · outpatient · +8 other terms	231	$66	$117	$119	101%	—	$28 – $543
4	WellCare fee schedule · outpatient · +1 other terms	169	$69	$70	$10	14%	—	$58 – $117
5	Blue Cross Blue Shield fee schedule · outpatient · +5 other terms	167	$63	$145	$283	196%	—	$0 – $2.4k
6	Devoted fee schedule · outpatient · +1 other terms	151	$68	$66	$4	6%	—	$58 – $72
7	Cigna Healthspring fee schedule · outpatient	104	$68	$67	$3	4%	—	$58 – $70
8	Molina fee schedule · outpatient · +3 other terms	89	$100	$93	$37	40%	—	$51 – $177
9	Cigna fee schedule · outpatient · +3 other terms	69	$65	$102	$217	214%	—	$58 – $1.7k
10	Superior Healthplan fee schedule · outpatient	39	$71	$71	—	—	—	$71 – $71
11	Anthem fee schedule · outpatient · +5 other terms	34	$68	$70	$16	22%	—	$58 – $152
12	Clover fee schedule · outpatient	32	$65	$65	$6	9%	—	$59 – $71
13	Bcbs Tx fee schedule · outpatient	31	$62	$64	$19	29%	—	$47 – $232
14	Kaiser fee schedule · outpatient · +3 other terms	24	$69	$67	$2	3%	—	$65 – $69
15	Optum fee schedule · outpatient · +1 other terms	24	$65	$76	$35	46%	—	$56 – $169
16	Oscar fee schedule · outpatient	24	$66	$64	$3	5%	—	$60 – $66
17	Amerihealth Caritas fee schedule · outpatient	16	$69	$68	$1	2%	—	$66 – $69
18	Caresource fee schedule · outpatient · +3 other terms	15	$58	$58	—	—	—	$58 – $58
19	Medicare fee schedule · outpatient	15	$65	$62	$3	5%	—	$59 – $66
20	Wellmark fee schedule · both · +1 other terms	13	$60	$74	$91	122%	—	$49 – $632
21	Bcbs Mn fee schedule · outpatient · +3 other terms	12	$529	$536	$139	26%	—	$267 – $644
22	Bcbs Nj fee schedule · outpatient	12	$59	$126	$86	68%	—	$59 – $259
23	Highmark fee schedule · outpatient · +3 other terms	10	$142	$144	$168	117%	—	$26 – $466
24	Medica fee schedule · outpatient · +4 other terms	10	$879	$837	$284	34%	—	$91 – $1.1k
25	Medical Mutual fee schedule · outpatient	9	$103	$103	—	—	—	$103 – $103

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