Pediatric folding tilt-in-space wheelchair, no seat system

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

Fld ped wc tltnspc w/o seat

Payers reporting HCPCS E1234

Payer pricing summary

Low

$53

Average

$1.0k

Median

$670

High

$9.3k

Payer rate distribution

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#
1	Humana fee schedule · outpatient · +6 other terms	247	$275	$443	$475	107%	—	$186 – $2.1k
2	Aetna fee schedule · outpatient · +5 other terms	236	$277	$591	$1.6k	268%	—	$101 – $18.1k
3	UnitedHealthcare fee schedule · outpatient · +8 other terms	232	$278	$509	$521	102%	—	$114 – $2.5k
4	Blue Cross Blue Shield fee schedule · outpatient · +5 other terms	178	$280	$651	$1.4k	208%	—	$0 – $11.6k
5	WellCare fee schedule · outpatient · +1 other terms	169	$283	$293	$48	16%	—	$270 – $536
6	Devoted fee schedule · outpatient · +1 other terms	151	$275	$276	$5	2%	—	$264 – $291
7	Cigna Healthspring fee schedule · outpatient	104	$280	$280	$8	3%	—	$275 – $297
8	Molina fee schedule · outpatient · +3 other terms	89	$405	$381	$148	39%	—	$229 – $720
9	Cigna fee schedule · outpatient · +3 other terms	69	$283	$469	$1.0k	222%	—	$264 – $8.1k
10	Superior Healthplan fee schedule · outpatient	39	$289	$289	—	—	—	$289 – $289
11	Anthem fee schedule · outpatient · +5 other terms	34	$275	$278	$29	11%	—	$264 – $448
12	Clover fee schedule · outpatient	32	$278	$279	$9	3%	—	$270 – $289
13	Bcbs Tx fee schedule · outpatient	31	$253	$259	$76	29%	—	$190 – $941
14	Kaiser fee schedule · outpatient · +3 other terms	24	$280	$274	$8	3%	—	$264 – $280
15	Optum fee schedule · outpatient	24	$275	$321	$136	42%	—	$264 – $687
16	Oscar fee schedule · outpatient	24	$269	$277	$9	3%	—	$269 – $289
17	Amerihealth Caritas fee schedule · outpatient	16	$330	$327	$6	2%	—	$313 – $330
18	Caresource fee schedule · outpatient · +3 other terms	15	$275	$275	—	—	—	$275 – $275
19	Medicare fee schedule · outpatient	15	$264	$264	$1	0%	—	$264 – $270
20	Wellmark fee schedule · both · +1 other terms	13	$1.3k	$1.3k	$1.1k	82%	—	$237 – $3.1k
21	Bcbs Mn fee schedule · outpatient · +3 other terms	12	$2.5k	$2.6k	$664	26%	—	$1.3k – $3.1k
22	Bcbs Nj fee schedule · outpatient	12	$270	$581	$395	68%	—	$270 – $1.2k
23	Highmark fee schedule · outpatient · +3 other terms	10	$853	$860	$819	95%	—	$127 – $2.2k
24	Medica fee schedule · outpatient · +4 other terms	10	$3.6k	$3.4k	$1.1k	34%	—	$432 – $4.6k
25	Medical Mutual fee schedule · outpatient	9	$493	$493	—	—	—	$493 – $493

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