Physician paperwork for equipment eligibility visit

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

MD document visit by NPP

Payers reporting HCPCS G0454

Payer pricing summary

Low

Average

$15

Median

$13

High

$35

Payer rate distribution

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#
1	Humana fee schedule · outpatient · +14 other terms	126	$17	$34	$31	93%	—	$8 – $89
2	Aetna fee schedule · outpatient · +14 other terms	80	$9	$15	$15	99%	—	$6 – $104
3	UnitedHealthcare fee schedule · outpatient · +17 other terms	65	$9	$11	$4	36%	—	$8 – $18
4	Anthem fee schedule · outpatient · +11 other terms	43	$30	$38	$26	67%	—	$8 – $105
5	Blue Cross Blue Shield facility · fee schedule · outpatient · +9 other terms	43	$25	$26	$15	58%	—	$5 – $71
6	Molina professional · fee schedule · outpatient · +11 other terms	28	$9	$9	$0	5%	—	$8 – $12
7	Cigna fee schedule · outpatient · +13 other terms	26	$9	$10	$4	40%	—	$8 – $25
8	Kaiser fee schedule · outpatient · +6 other terms	25	$9	$8	$0	2%	—	$8 – $9
9	Devoted fee schedule · outpatient · +7 other terms	21	$9	$8	$0	1%	—	$8 – $9
10	Regence professional · fee schedule · outpatient · +3 other terms	21	$9	$9	$2	25%	—	$9 – $22
11	Caresource facility · case rate · outpatient · +9 other terms	20	$56	$49	$26	52%	—	$8 – $100
12	Medicare fee schedule · outpatient · +6 other terms	18	$8	$8	$0	2%	—	$8 – $9
13	WellCare fee schedule · both · +10 other terms	18	$8	$9	$2	18%	—	$7 – $14
14	Wellmark fee schedule · both · +3 other terms	13	$16	$16	$5	29%	—	$8 – $20
15	Aetna Better Health fee schedule · outpatient · +4 other terms	12	$9	$9	$0	5%	—	$8 – $9
16	Ambetter fee schedule · both · +10 other terms	12	$11	$16	$2	16%	—	$8 – $17
17	Bcbs Mn fee schedule · outpatient · +4 other terms	12	$41	$33	$16	50%	—	$9 – $52
18	Cigna Healthspring fee schedule · both · +2 other terms	12	$8	$8	$0	1%	—	$8 – $9
19	Highmark fee schedule · outpatient · +6 other terms	12	$9	$10	$3	29%	—	$8 – $31
20	Optum facility · case rate · outpatient · +5 other terms	12	$53	$52	$22	43%	—	$9 – $89
21	MultiPlan fee schedule · both · +6 other terms	11	$16	$16	$1	5%	—	$14 – $18
22	Medica fee schedule · outpatient · +6 other terms	10	$30	$30	$9	28%	—	$13 – $39
23	Medical Mutual facility · fee schedule · outpatient · +2 other terms	10	$9	$11	$2	21%	—	$9 – $14
24	Oscar fee schedule · outpatient · +4 other terms	10	$7	$7	$6	80%	—	$1 – $15
25	Bcbs Il professional · fee schedule · both · +1 other terms	9	$7	$7	$5	70%	—	$0 – $17

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