Replacement solid drive 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

Solid drive wheel tire

Payers reporting HCPCS E2390

Payer pricing summary

Low

Average

$49

Median

$45

High

$173

Payer rate distribution

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#
1	Humana fee schedule · outpatient · +6 other terms	267	$51	$44	$19	43%	—	$4 – $206
2	Aetna fee schedule · outpatient · +5 other terms	259	$52	$53	$38	72%	—	$2 – $340
3	UnitedHealthcare fee schedule · outpatient · +8 other terms	256	$52	$38	$19	50%	—	$2 – $64
4	WellCare fee schedule · outpatient · +2 other terms	185	$53	$55	$9	16%	—	$50 – $100
5	Blue Cross Blue Shield fee schedule · outpatient · +5 other terms	181	$53	$57	$24	42%	—	$0 – $169
6	Devoted fee schedule · outpatient · +1 other terms	165	$52	$49	$11	22%	—	$5 – $59
7	Cigna Healthspring fee schedule · outpatient	111	$54	$52	$1	3%	—	$52 – $56
8	Molina fee schedule · outpatient · +3 other terms	96	$64	$56	$32	57%	—	$4 – $136
9	Cigna fee schedule · outpatient · +3 other terms	77	$53	$45	$29	64%	—	$5 – $149
10	Superior Healthplan fee schedule · outpatient	40	$54	$54	$0	0%	—	$54 – $55
11	Anthem fee schedule · outpatient · +5 other terms	38	$52	$36	$19	53%	—	$5 – $54
12	Clover fee schedule · outpatient	34	$54	$52	$2	4%	—	$50 – $55
13	Bcbs Tx fee schedule · outpatient	31	$50	$51	$15	29%	—	$38 – $188
14	Optum fee schedule · outpatient · +2 other terms	28	$52	$39	$26	66%	—	$5 – $129
15	Kaiser fee schedule · outpatient · +2 other terms	27	$52	$35	$19	56%	—	$5 – $55
16	Oscar fee schedule · outpatient	24	$50	$52	$2	3%	—	$50 – $54
17	Medicare fee schedule · outpatient	18	$31	$31	$19	62%	—	$5 – $55
18	Amerihealth Caritas fee schedule · outpatient · +1 other terms	17	$62	$61	$1	2%	—	$59 – $62
19	Caresource fee schedule · outpatient · +3 other terms	15	$52	$52	—	—	—	$52 – $52
20	Wellmark fee schedule · both · +1 other terms	13	$25	$25	$21	82%	—	$4 – $46
21	Bcbs Mn fee schedule · outpatient · +3 other terms	12	$45	$46	$12	26%	—	$23 – $55
22	Bcbs Nj fee schedule · outpatient	12	$50	$108	$73	68%	—	$50 – $222
23	MultiPlan facility · fee schedule · outpatient · +2 other terms	11	$15	$26	$33	128%	—	$15 – $129
24	Highmark fee schedule · outpatient · +3 other terms	10	$31	$33	$27	82%	—	$2 – $131
25	Medica fee schedule · outpatient · +4 other terms	10	$99	$95	$32	34%	—	$8 – $128

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