Wheelchair seat depth, custom upholstery

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 special seat dept

Payers reporting HCPCS E1297

Payer pricing summary

Low

Average

$131

Median

$124

High

$500

Payer rate distribution

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#
1	Humana fee schedule · outpatient · +6 other terms	247	$127	$123	$50	40%	—	$11 – $596
2	Aetna fee schedule · outpatient · +5 other terms	236	$131	$140	$84	60%	—	$6 – $783
3	UnitedHealthcare fee schedule · outpatient · +8 other terms	231	$129	$106	$47	44%	—	$7 – $152
4	WellCare fee schedule · outpatient · +2 other terms	169	$134	$140	$23	17%	—	$124 – $247
5	Blue Cross Blue Shield fee schedule · outpatient · +5 other terms	167	$148	$144	$54	37%	—	$0 – $479
6	Devoted fee schedule · outpatient · +1 other terms	151	$134	$129	$22	17%	—	$16 – $149
7	Cigna Healthspring fee schedule · outpatient	104	$149	$136	$14	10%	—	$127 – $160
8	Molina fee schedule · outpatient · +3 other terms	89	$185	$162	$79	49%	—	$14 – $332
9	Cigna fee schedule · outpatient · +3 other terms	69	$136	$126	$68	54%	—	$15 – $431
10	Superior Healthplan fee schedule · outpatient	39	$133	$133	—	—	—	$133 – $133
11	Anthem fee schedule · outpatient · +5 other terms	34	$149	$114	$50	44%	—	$16 – $154
12	Clover fee schedule · outpatient	32	$128	$130	$8	6%	—	$124 – $157
13	Bcbs Tx fee schedule · outpatient	31	$117	$119	$35	29%	—	$88 – $434
14	Kaiser fee schedule · outpatient · +3 other terms	24	$152	$110	$53	48%	—	$16 – $152
15	Optum fee schedule · outpatient · +1 other terms	24	$129	$119	$72	61%	—	$16 – $317
16	Oscar fee schedule · outpatient	24	$124	$138	$16	12%	—	$124 – $157
17	Amerihealth Caritas fee schedule · outpatient · +1 other terms	16	$179	$174	$10	6%	—	$152 – $179
18	Caresource fee schedule · outpatient · +3 other terms	15	$149	$149	—	—	—	$149 – $149
19	Medicare fee schedule · outpatient	15	$89	$89	$54	60%	—	$16 – $146
20	Wellmark fee schedule · both · +1 other terms	13	$72	$72	$59	82%	—	$12 – $132
21	Bcbs Mn fee schedule · outpatient · +3 other terms	12	$129	$130	$34	26%	—	$65 – $156
22	Bcbs Nj fee schedule · outpatient	12	$124	$268	$182	68%	—	$124 – $550
23	Highmark fee schedule · outpatient · +3 other terms	10	$73	$76	$62	82%	—	$6 – $298
24	Medica fee schedule · outpatient · +4 other terms	10	$285	$271	$93	34%	—	$22 – $368
25	Medical Mutual fee schedule · outpatient	9	$141	$141	$85	60%	—	$25 – $227

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