Pavlik harness for infant hip abduction

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

Pavlik Harness

Payers reporting HCPCS L1620

Payer pricing summary

Low

$50

Average

$218

Median

$193

High

$1.1k

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +22 other terms	403	$168	$188	$118	63%	—	$1 – $2.3k
2	Aetna fee schedule · outpatient · +21 other terms	378	$169	$235	$276	117%	—	$46 – $2.7k
3	Humana fee schedule · outpatient · +21 other terms	333	$166	$247	$266	108%	—	$46 – $2.6k
4	Blue Cross Blue Shield fee schedule · outpatient · +20 other terms	244	$169	$245	$192	78%	—	$0 – $2.3k
5	WellCare fee schedule · outpatient · +10 other terms	217	$163	$170	$38	22%	—	$48 – $642
6	Devoted fee schedule · outpatient · +4 other terms	165	$159	$158	$8	5%	—	$148 – $209
7	Molina fee schedule · outpatient · +16 other terms	154	$214	$206	$75	36%	—	$76 – $403
8	Cigna fee schedule · outpatient · +18 other terms	128	$171	$257	$196	76%	—	$110 – $2.0k
9	Cigna Healthspring fee schedule · outpatient · +2 other terms	121	$171	$162	$13	8%	—	$154 – $211
10	Anthem fee schedule · outpatient · +17 other terms	94	$163	$298	$264	89%	—	$46 – $1.4k
11	Kaiser fee schedule · outpatient · +15 other terms	75	$157	$379	$275	72%	—	$46 – $1.2k
12	Caresource fee schedule · outpatient · +8 other terms	43	$189	$203	$160	79%	—	$91 – $1.4k
13	Optum fee schedule · outpatient · +10 other terms	41	$166	$203	$77	38%	—	$111 – $385
14	Superior Healthplan fee schedule · outpatient · +2 other terms	40	$162	$162	$1	0%	—	$151 – $162
15	Clover fee schedule · outpatient · +2 other terms	37	$167	$169	$7	4%	—	$162 – $205
16	Ambetter facility · fee schedule · outpatient · +8 other terms	36	$331	$325	$71	22%	—	$140 – $415
17	Oscar fee schedule · outpatient · +7 other terms	36	$174	$193	$56	29%	—	$151 – $325
18	Medica facility · fee schedule · outpatient · +11 other terms	24	$136	$138	$62	45%	—	$21 – $270
19	MultiPlan fee schedule · outpatient · +16 other terms	24	$619	$694	$579	83%	—	$135 – $3.1k
20	Medicare fee schedule · outpatient · +4 other terms	19	$148	$149	$2	1%	—	$148 – $154
21	Regence facility · fee schedule · outpatient · +7 other terms	19	$160	$157	$7	5%	—	$135 – $163
22	Amerihealth Caritas fee schedule · outpatient · +6 other terms	18	$199	$197	$5	2%	—	$189 – $199
23	Bcbs Tx fee schedule · outpatient	18	$151	$151	—	—	—	$151 – $151
24	Medical Mutual facility · fee schedule · outpatient · +4 other terms	15	$193	$222	$55	25%	—	$105 – $305
25	First Health fee schedule · outpatient · +10 other terms	14	$514	$485	$182	38%	—	$151 – $765

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