Wheelchair back cushion, under 22 inches wide

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

Position back cush wd <22in

Payers reporting HCPCS E2613

Payer pricing summary

Low

Average

$394

Median

$362

High

$1.3k

Payer rate distribution

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#
1	Humana fee schedule · outpatient · +5 other terms	267	$376	$336	$144	43%	—	$27 – $1.5k
2	Aetna fee schedule · outpatient · +5 other terms	259	$383	$424	$322	76%	—	$18 – $2.9k
3	UnitedHealthcare fee schedule · outpatient · +8 other terms	256	$383	$299	$157	52%	—	$19 – $552
4	WellCare fee schedule · outpatient · +2 other terms	185	$394	$403	$61	15%	—	$346 – $689
5	Blue Cross Blue Shield fee schedule · outpatient · +5 other terms	181	$394	$475	$215	45%	—	$0 – $1.6k
6	Devoted fee schedule · outpatient · +1 other terms	165	$383	$366	$82	23%	—	$37 – $507
7	Cigna Healthspring fee schedule · outpatient	111	$398	$385	$23	6%	—	$371 – $484
8	Molina fee schedule · outpatient · +3 other terms	96	$477	$431	$241	56%	—	$32 – $1.2k
9	Cigna fee schedule · outpatient · +3 other terms	77	$394	$371	$235	63%	—	$37 – $1.1k
10	Superior Healthplan fee schedule · outpatient	40	$390	$392	$14	4%	—	$390 – $471
11	Anthem fee schedule · outpatient · +5 other terms	38	$390	$289	$154	53%	—	$37 – $473
12	Clover fee schedule · outpatient	34	$390	$380	$36	9%	—	$346 – $471
13	Bcbs Tx fee schedule · outpatient	31	$426	$444	$135	30%	—	$335 – $1.7k
14	Optum fee schedule · outpatient · +2 other terms	28	$383	$314	$196	63%	—	$37 – $928
15	Kaiser fee schedule · outpatient · +2 other terms	27	$394	$284	$159	56%	—	$37 – $473
16	Oscar fee schedule · outpatient	24	$364	$380	$19	5%	—	$364 – $402
17	Medicare fee schedule · outpatient	18	$258	$261	$163	63%	—	$37 – $473
18	Amerihealth Caritas fee schedule · outpatient · +1 other terms	17	$459	$464	$24	5%	—	$436 – $538
19	Caresource fee schedule · outpatient · +3 other terms	15	$383	$383	—	—	—	$383 – $383
20	Wellmark fee schedule · both · +1 other terms	13	$217	$215	$177	82%	—	$28 – $394
21	Bcbs Mn fee schedule · outpatient · +3 other terms	12	$387	$397	$104	26%	—	$195 – $473
22	Bcbs Nj fee schedule · outpatient	12	$346	$747	$507	68%	—	$346 – $1.5k
23	MultiPlan facility · fee schedule · outpatient · +1 other terms	11	$131	$227	$302	133%	—	$131 – $1.2k
24	Highmark fee schedule · outpatient · +3 other terms	10	$264	$273	$227	83%	—	$16 – $1.1k
25	Medica fee schedule · outpatient · +4 other terms	10	$741	$708	$240	34%	—	$58 – $957

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