Ankle motion assist and resistance add-on for lower-limb orthosis

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

Addition Le Dorsiflex Ea T1

Payers reporting HCPCS L2220

Payer pricing summary

Low

$33

Average

$166

Median

$128

High

$528

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +21 other terms	397	$103	$147	$133	90%	—	$1 – $1.0k
2	Aetna fee schedule · outpatient · +19 other terms	367	$104	$132	$81	62%	—	$33 – $993
3	Humana fee schedule · outpatient · +20 other terms	321	$105	$153	$160	105%	—	$51 – $772
4	Blue Cross Blue Shield fee schedule · outpatient · +19 other terms	239	$104	$170	$156	92%	—	$0 – $1.4k
5	WellCare fee schedule · outpatient · +10 other terms	213	$104	$108	$20	19%	—	$27 – $208
6	Devoted fee schedule · outpatient · +5 other terms	165	$102	$104	$6	6%	—	$96 – $128
7	Molina fee schedule · outpatient · +15 other terms	151	$136	$137	$53	39%	—	$56 – $263
8	Cigna fee schedule · outpatient · +16 other terms	130	$117	$242	$213	88%	—	$69 – $1.1k
9	Cigna Healthspring fee schedule · outpatient · +3 other terms	116	$105	$104	$7	6%	—	$98 – $129
10	Anthem fee schedule · outpatient · +17 other terms	100	$120	$218	$185	85%	—	$26 – $828
11	Kaiser fee schedule · outpatient · +14 other terms	80	$124	$207	$177	86%	—	$73 – $1.2k
12	Ambetter facility · fee schedule · outpatient · +8 other terms	47	$178	$183	$45	25%	—	$72 – $254
13	Caresource fee schedule · outpatient · +8 other terms	44	$102	$101	$23	23%	—	$52 – $154
14	Superior Healthplan fee schedule · outpatient · +3 other terms	40	$105	$105	$1	0%	—	$98 – $105
15	Clover fee schedule · outpatient · +3 other terms	37	$105	$106	$3	3%	—	$102 – $125
16	Oscar fee schedule · outpatient · +6 other terms	36	$107	$121	$37	30%	—	$98 – $213
17	Optum fee schedule · outpatient · +7 other terms	35	$117	$184	$150	82%	—	$62 – $826
18	MultiPlan fee schedule · outpatient · +14 other terms	26	$466	$528	$318	60%	—	$98 – $1.4k
19	Medica facility · fee schedule · outpatient · +10 other terms	22	$102	$95	$25	26%	—	$33 – $161
20	Medicare fee schedule · outpatient · +3 other terms	19	$117	$117	$5	4%	—	$94 – $120
21	Amerihealth Caritas fee schedule · outpatient · +5 other terms	18	$122	$118	$8	7%	—	$96 – $122
22	Bcbs Tx fee schedule · outpatient	18	$98	$98	—	—	—	$98 – $98
23	First Health fee schedule · outpatient · +8 other terms	17	$431	$501	$295	59%	—	$98 – $1.2k
24	Regence facility · fee schedule · outpatient · +7 other terms	17	$127	$122	$12	9%	—	$93 – $129
25	Tricare facility · fee schedule · outpatient · +7 other terms	16	$95	$101	$10	10%	—	$92 – $120

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