Symes-type lower leg prosthesis addition with PTB socket

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

Le - Ptb Brim Design Socket

Payers reporting HCPCS L5632

Payer pricing summary

Low

$75

Average

$371

Median

$347

High

$722

Payer rate distribution

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#
1	Aetna fee schedule · outpatient · +15 other terms	361	$305	$357	$188	53%	—	$144 – $2.4k
2	UnitedHealthcare fee schedule · outpatient · +16 other terms	358	$303	$298	$95	32%	—	$122 – $1.2k
3	Humana fee schedule · outpatient · +13 other terms	319	$300	$429	$431	101%	—	$173 – $2.1k
4	Blue Cross Blue Shield fee schedule · outpatient · +11 other terms	219	$306	$395	$219	55%	—	$0 – $1.3k
5	WellCare fee schedule · outpatient · +6 other terms	208	$309	$305	$56	18%	—	$267 – $578
6	Devoted fee schedule · outpatient · +4 other terms	165	$300	$288	$21	7%	—	$272 – $370
7	Molina fee schedule · outpatient · +6 other terms	140	$400	$396	$153	39%	—	$162 – $725
8	Cigna Healthspring fee schedule · outpatient · +2 other terms	116	$309	$289	$25	9%	—	$272 – $373
9	Cigna fee schedule · outpatient · +13 other terms	104	$321	$350	$105	30%	—	$190 – $971
10	Anthem fee schedule · outpatient · +8 other terms	80	$328	$437	$443	101%	—	$196 – $2.5k
11	Kaiser fee schedule · outpatient · +6 other terms	64	$341	$560	$426	76%	—	$321 – $2.7k
12	Ambetter facility · fee schedule · outpatient · +6 other terms	47	$429	$535	$142	26%	—	$241 – $751
13	Superior Healthplan fee schedule · outpatient	40	$285	$285	$1	0%	—	$267 – $285
14	Clover fee schedule · outpatient · +3 other terms	37	$290	$298	$15	5%	—	$285 – $362
15	Oscar fee schedule · outpatient · +4 other terms	36	$315	$335	$81	24%	—	$266 – $524
16	Optum fee schedule · outpatient · +4 other terms	33	$321	$384	$127	33%	—	$272 – $680
17	Caresource fee schedule · outpatient · +5 other terms	29	$300	$326	$105	32%	—	$164 – $512
18	Medica facility · fee schedule · outpatient · +5 other terms	22	$339	$310	$79	25%	—	$111 – $514
19	Regence facility · fee schedule · outpatient · +4 other terms	19	$348	$344	$13	4%	—	$302 – $354
20	Amerihealth Caritas fee schedule · outpatient · +2 other terms	18	$360	$348	$26	7%	—	$277 – $360
21	Bcbs Tx fee schedule · outpatient	18	$267	$267	—	—	—	$267 – $267
22	Medicare fee schedule · outpatient · +3 other terms	18	$321	$322	$2	1%	—	$321 – $328
23	Tricare facility · fee schedule · outpatient · +2 other terms	16	$272	$284	$20	7%	—	$266 – $328
24	Medical Mutual facility · fee schedule · outpatient · +2 other terms	15	$332	$381	$94	25%	—	$180 – $524
25	Highmark facility · fee schedule · outpatient · +5 other terms	14	$503	$481	$196	41%	—	$261 – $778

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