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.
Original text from hospital filings
Custom fab w/c back cushion
Low
$0
Average
$973
Median
$691
High
$3.0k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
21 payers; the 90th percentile is 6.7× the 10th. Each bar is a price range and its height is how many payers fall in it. Hover a bar, or a row in the ladder, for details.
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| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Blue Cross Blue Shield facility · fee schedule · outpatient · +6 other terms | 22 | $3.3k | $3.2k | $2.6k | 80% | — | $108 – $8.6k |
| 2 | Aetna fee schedule · outpatient · +7 other terms | 19 | $336 | $1.6k | $2.8k | 170% | — | $336 – $10.4k |
| 3 | Anthem facility · case rate · outpatient · +4 other terms | 15 | $607 | $663 | $156 | 23% | — | $413 – $1.0k |
| 4 | Caresource facility · case rate · outpatient · +1 other terms | 15 | $618 | $664 | $152 | 23% | — | $413 – $1.0k |
| 5 | Molina facility · case rate · outpatient · +1 other terms | 15 | $607 | $664 | $154 | 23% | — | $425 – $1.0k |
| 6 | UnitedHealthcare facility · case rate · outpatient · +4 other terms | 15 | $618 | $672 | $158 | 23% | — | $425 – $1.0k |
| 7 | Wellmark fee schedule · both · +1 other terms | 13 | $393 | $421 | $400 | 95% | — | $71 – $2.5k |
| 8 | Optum facility · case rate · outpatient | 11 | $572 | $628 | $140 | 22% | — | $516 – $931 |
| 9 | Cigna professional · fee schedule · outpatient · +3 other terms | 10 | $344 | $338 | $14 | 4% | — | $304 – $344 |
| 10 | Aetna Better Health fee schedule · inpatient · +1 other terms | 7 | $346 | $346 | — | — | — | $346 – $346 |
| 11 | Humana fee schedule · inpatient · +4 other terms | 5 | $336 | $336 | — | — | — | $336 – $336 |
| 12 | First Health professional · fee schedule · both | 3 | $370 | $370 | — | — | — | $370 – $370 |
| 13 | Bcbs Il professional · fee schedule · both | 1 | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 14 | Bcbs La facility · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 15 | Bcbs Nc facility · fee schedule · outpatient | 1 | $3.0k | $3.0k | — | — | — | $3.0k – $3.0k |
| 16 | Bcbs Nv fee schedule · outpatient | 1 | $324 | $324 | $199 | 62% | — | $53 – $525 |
| 17 | Bcbs Vt professional · fee schedule · outpatient | 1 | $696 | $696 | — | — | — | $696 – $696 |
| 18 | Healthpartners facility · fee schedule · outpatient | 1 | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
| 19 | Medica facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms | 1 | $755 | $755 | $771 | 102% | — | $44 – $2.4k |
| 20 | MultiPlan facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms | 1 | $985 | $985 | $987 | 100% | — | $66 – $2.7k |
| 21 | Ucare facility · percent of total billed charges · outpatientfrom % of charges | 1 | $463 | $463 | $464 | 100% | — | $31 – $1.3k |
← Hospitals reporting HCPCS E2617 · Snapshot 20261112T181611Z-3fa9fb76