Wheelchair with fixed arms and elevating 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

Wheelchair spec size w/ leg

Payers reporting HCPCS E1222

Payer pricing summary

Low

Average

$324

Median

$177

High

$3.2k

Payer rate distribution

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#
1	Humana fee schedule · outpatient · +6 other terms	247	$95	$146	$161	110%	—	$65 – $710
2	Aetna fee schedule · outpatient · +5 other terms	236	$93	$214	$679	318%	—	$30 – $8.0k
3	UnitedHealthcare fee schedule · outpatient · +8 other terms	232	$93	$174	$188	108%	—	$40 – $911
4	Blue Cross Blue Shield fee schedule · outpatient · +5 other terms	178	$94	$210	$430	205%	—	$0 – $3.4k
5	WellCare fee schedule · outpatient · +1 other terms	169	$95	$97	$18	19%	—	$82 – $188
6	Devoted fee schedule · outpatient · +1 other terms	151	$92	$91	$4	5%	—	$82 – $98
7	Cigna Healthspring fee schedule · outpatient	104	$92	$92	$3	4%	—	$82 – $100
8	Molina fee schedule · outpatient · +3 other terms	89	$136	$128	$50	39%	—	$68 – $242
9	Cigna fee schedule · outpatient · +3 other terms	69	$93	$157	$357	227%	—	$83 – $2.8k
10	Superior Healthplan fee schedule · outpatient	39	$97	$97	—	—	—	$97 – $97
11	Anthem fee schedule · outpatient · +5 other terms	34	$97	$99	$16	17%	—	$82 – $172
12	Clover fee schedule · outpatient	32	$96	$96	$2	2%	—	$95 – $101
13	Bcbs Tx fee schedule · outpatient	31	$85	$87	$26	29%	—	$64 – $316
14	Kaiser fee schedule · outpatient · +3 other terms	24	$99	$96	$3	3%	—	$93 – $99
15	Optum fee schedule · outpatient · +1 other terms	24	$93	$107	$46	43%	—	$82 – $231
16	Oscar fee schedule · outpatient	24	$91	$89	$2	2%	—	$86 – $91
17	Amerihealth Caritas fee schedule · outpatient	16	$99	$98	$2	2%	—	$94 – $99
18	Caresource fee schedule · outpatient · +3 other terms	15	$82	$82	—	—	—	$82 – $82
19	Medicare fee schedule · outpatient	15	$93	$86	$7	8%	—	$79 – $95
20	Wellmark fee schedule · both · +1 other terms	13	$85	$106	$129	122%	—	$69 – $902
21	Bcbs Mn fee schedule · outpatient · +3 other terms	12	$866	$877	$227	26%	—	$437 – $1.1k
22	Bcbs Nj fee schedule · outpatient	12	$95	$204	$139	68%	—	$95 – $419
23	Highmark fee schedule · outpatient · +3 other terms	10	$239	$242	$282	117%	—	$44 – $781
24	Medica fee schedule · outpatient · +4 other terms	10	$1.3k	$1.2k	$404	34%	—	$135 – $1.6k
25	Medical Mutual fee schedule · outpatient	9	$173	$173	—	—	—	$173 – $173

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