Wheelchair with detachable 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 E1223

Payer pricing summary

Low

Average

$344

Median

$187

High

$3.2k

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	Humana fee schedule · outpatient · +6 other terms	247	$103	$163	$184	113%	—	$68 – $811
2	Aetna fee schedule · outpatient · +5 other terms	236	$103	$212	$554	261%	—	$33 – $6.2k
3	UnitedHealthcare fee schedule · outpatient · +8 other terms	232	$103	$182	$180	99%	—	$44 – $808
4	Blue Cross Blue Shield fee schedule · outpatient · +5 other terms	178	$100	$223	$439	197%	—	$0 – $3.7k
5	WellCare fee schedule · outpatient · +1 other terms	169	$108	$109	$20	18%	—	$90 – $206
6	Devoted fee schedule · outpatient · +1 other terms	151	$105	$102	$6	6%	—	$90 – $112
7	Cigna Healthspring fee schedule · outpatient	104	$97	$103	$5	5%	—	$90 – $108
8	Molina fee schedule · outpatient · +3 other terms	89	$155	$146	$57	39%	—	$76 – $276
9	Cigna fee schedule · outpatient · +3 other terms	69	$101	$166	$353	213%	—	$91 – $2.7k
10	Superior Healthplan fee schedule · outpatient	39	$111	$111	—	—	—	$111 – $111
11	Anthem fee schedule · outpatient · +5 other terms	34	$102	$102	$10	10%	—	$90 – $152
12	Clover fee schedule · outpatient	32	$107	$107	$4	3%	—	$103 – $111
13	Bcbs Tx fee schedule · outpatient	31	$97	$99	$29	29%	—	$73 – $361
14	Kaiser fee schedule · outpatient · +3 other terms	24	$108	$105	$3	3%	—	$101 – $108
15	Optum fee schedule · outpatient · +1 other terms	24	$101	$116	$55	47%	—	$91 – $264
16	Oscar fee schedule · outpatient	24	$103	$100	$5	5%	—	$94 – $103
17	Amerihealth Caritas fee schedule · outpatient	16	$108	$107	$2	2%	—	$102 – $108
18	Caresource fee schedule · outpatient · +3 other terms	15	$90	$90	—	—	—	$90 – $90
19	Medicare fee schedule · outpatient	15	$101	$95	$7	7%	—	$87 – $103
20	Wellmark fee schedule · both · +1 other terms	13	$88	$111	$142	128%	—	$76 – $985
21	Bcbs Mn fee schedule · outpatient · +3 other terms	12	$857	$869	$225	26%	—	$433 – $1.0k
22	Bcbs Nj fee schedule · outpatient	12	$103	$223	$151	68%	—	$103 – $458
23	Highmark fee schedule · outpatient · +3 other terms	10	$256	$259	$302	117%	—	$48 – $837
24	Medica fee schedule · outpatient · +4 other terms	10	$1.4k	$1.3k	$442	34%	—	$143 – $1.8k
25	Medical Mutual fee schedule · outpatient	9	$186	$186	—	—	—	$186 – $186

Page 1 of 2 · 46 payers