Wheelchair back cushion with lateral supports

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

WC planar back cush wd>=22in

Payers reporting HCPCS E2621

Payer pricing summary

Low

$14

Average

$555

Median

$511

High

$1.8k

Payer rate distribution

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#
1	Humana fee schedule · outpatient · +5 other terms	267	$534	$489	$210	43%	—	$40 – $2.2k
2	Aetna fee schedule · outpatient · +5 other terms	259	$558	$619	$479	77%	—	$26 – $4.6k
3	UnitedHealthcare fee schedule · outpatient · +8 other terms	256	$556	$442	$224	51%	—	$27 – $804
4	WellCare fee schedule · outpatient · +2 other terms	185	$562	$590	$90	15%	—	$507 – $1.0k
5	Blue Cross Blue Shield fee schedule · outpatient · +5 other terms	181	$575	$693	$316	46%	—	$0 – $2.3k
6	Devoted fee schedule · outpatient · +1 other terms	165	$558	$533	$121	23%	—	$52 – $738
7	Cigna Healthspring fee schedule · outpatient	111	$581	$562	$33	6%	—	$540 – $705
8	Molina fee schedule · outpatient · +3 other terms	96	$696	$630	$353	56%	—	$45 – $1.7k
9	Cigna fee schedule · outpatient · +3 other terms	77	$565	$531	$349	66%	—	$52 – $1.6k
10	Superior Healthplan fee schedule · outpatient	40	$573	$576	$19	3%	—	$573 – $685
11	Anthem fee schedule · outpatient · +5 other terms	38	$540	$413	$222	54%	—	$52 – $692
12	Clover fee schedule · outpatient	34	$573	$556	$51	9%	—	$507 – $685
13	Bcbs Tx fee schedule · outpatient	31	$624	$649	$197	30%	—	$489 – $2.4k
14	Optum fee schedule · outpatient · +2 other terms	28	$558	$452	$288	64%	—	$52 – $1.4k
15	Kaiser fee schedule · outpatient · +2 other terms	27	$545	$405	$227	56%	—	$52 – $692
16	Oscar fee schedule · outpatient	24	$534	$556	$26	5%	—	$534 – $586
17	Medicare fee schedule · outpatient	18	$368	$373	$237	63%	—	$52 – $692
18	Amerihealth Caritas fee schedule · outpatient · +1 other terms	17	$670	$677	$34	5%	—	$637 – $783
19	Caresource fee schedule · outpatient · +3 other terms	15	$558	$558	—	—	—	$558 – $558
20	Wellmark fee schedule · both · +1 other terms	13	$316	$313	$257	82%	—	$40 – $574
21	Bcbs Mn fee schedule · outpatient · +3 other terms	12	$563	$579	$152	26%	—	$284 – $692
22	Bcbs Nj fee schedule · outpatient	12	$507	$1.1k	$743	68%	—	$507 – $2.2k
23	MultiPlan facility · fee schedule · outpatient · +1 other terms	11	$191	$331	$442	134%	—	$191 – $1.7k
24	Highmark fee schedule · outpatient · +3 other terms	10	$385	$399	$331	83%	—	$24 – $1.7k
25	Medica fee schedule · outpatient · +4 other terms	10	$1.0k	$1.0k	$339	34%	—	$85 – $1.4k

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