Replacement foam-filled caster tire for power wheelchair

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

Foam filled caster tire

Payers reporting HCPCS E2387

Payer pricing summary

Low

Average

$63

Median

$57

High

$201

Payer rate distribution

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#
1	Humana fee schedule · outpatient · +6 other terms	267	$60	$54	$24	44%	—	$4 – $247
2	Aetna fee schedule · outpatient · +5 other terms	259	$62	$69	$54	78%	—	$3 – $512
3	UnitedHealthcare fee schedule · outpatient · +8 other terms	256	$62	$50	$26	52%	—	$3 – $92
4	WellCare fee schedule · outpatient · +2 other terms	185	$63	$64	$10	15%	—	$54 – $107
5	Blue Cross Blue Shield fee schedule · outpatient · +5 other terms	181	$64	$78	$36	47%	—	$0 – $263
6	Devoted fee schedule · outpatient · +1 other terms	165	$62	$58	$13	23%	—	$6 – $84
7	Cigna Healthspring fee schedule · outpatient	111	$64	$61	$4	7%	—	$58 – $80
8	Molina fee schedule · outpatient · +3 other terms	96	$78	$69	$39	56%	—	$5 – $191
9	Cigna fee schedule · outpatient · +3 other terms	77	$64	$60	$40	66%	—	$6 – $173
10	Superior Healthplan fee schedule · outpatient	40	$61	$62	$3	4%	—	$61 – $76
11	Anthem fee schedule · outpatient · +5 other terms	38	$63	$48	$26	54%	—	$6 – $81
12	Clover fee schedule · outpatient	34	$61	$60	$7	12%	—	$54 – $78
13	Bcbs Tx fee schedule · outpatient	31	$70	$73	$22	31%	—	$55 – $273
14	Optum fee schedule · outpatient · +2 other terms	28	$62	$52	$32	62%	—	$6 – $146
15	Kaiser fee schedule · outpatient · +2 other terms	27	$64	$47	$26	56%	—	$6 – $81
16	Oscar fee schedule · outpatient	24	$57	$60	$4	6%	—	$57 – $65
17	Medicare fee schedule · outpatient	18	$43	$44	$28	63%	—	$6 – $81
18	Amerihealth Caritas fee schedule · outpatient · +1 other terms	17	$74	$75	$4	6%	—	$70 – $87
19	Caresource fee schedule · outpatient · +3 other terms	15	$62	$62	—	—	—	$62 – $62
20	Wellmark fee schedule · both · +1 other terms	13	$35	$35	$28	82%	—	$5 – $63
21	Bcbs Mn fee schedule · outpatient · +3 other terms	12	$64	$66	$18	26%	—	$32 – $81
22	Bcbs Nj fee schedule · outpatient	12	$54	$116	$79	68%	—	$54 – $238
23	MultiPlan facility · fee schedule · outpatient · +2 other terms	11	$22	$38	$51	135%	—	$22 – $200
24	Highmark fee schedule · outpatient · +3 other terms	10	$44	$45	$38	83%	—	$3 – $195
25	Medica fee schedule · outpatient · +4 other terms	10	$115	$110	$37	34%	—	$9 – $148

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