Addition to lower leg prosthesis for Syme amputation 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

Symes type medial opening so

Payers reporting HCPCS L5636

Payer pricing summary

Low

$81

Average

$403

Median

$370

High

$880

Payer rate distribution

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#
1	Aetna fee schedule · outpatient · +14 other terms	361	$319	$398	$203	51%	—	$149 – $2.6k
2	UnitedHealthcare fee schedule · outpatient · +15 other terms	358	$318	$333	$102	30%	—	$153 – $1.3k
3	Humana fee schedule · outpatient · +13 other terms	319	$321	$481	$496	103%	—	$166 – $2.4k
4	Blue Cross Blue Shield fee schedule · outpatient · +11 other terms	219	$318	$421	$226	54%	—	$0 – $1.5k
5	WellCare fee schedule · outpatient · +6 other terms	208	$322	$348	$90	26%	—	$306 – $811
6	Devoted fee schedule · outpatient · +4 other terms	165	$312	$325	$31	10%	—	$312 – $424
7	Molina fee schedule · outpatient · +6 other terms	140	$459	$446	$171	38%	—	$185 – $831
8	Cigna Healthspring fee schedule · outpatient · +2 other terms	116	$324	$326	$28	9%	—	$312 – $428
9	Cigna fee schedule · outpatient · +13 other terms	104	$361	$391	$115	29%	—	$267 – $1.0k
10	Anthem fee schedule · outpatient · +8 other terms	80	$408	$478	$410	86%	—	$175 – $2.4k
11	Kaiser fee schedule · outpatient · +6 other terms	64	$424	$624	$439	70%	—	$359 – $2.8k
12	Ambetter facility · fee schedule · outpatient · +6 other terms	44	$560	$583	$132	23%	—	$306 – $877
13	Superior Healthplan fee schedule · outpatient	40	$328	$327	$2	0%	—	$306 – $328
14	Clover fee schedule · outpatient · +3 other terms	37	$408	$365	$42	12%	—	$312 – $416
15	Oscar fee schedule · outpatient · +4 other terms	36	$328	$363	$81	22%	—	$306 – $537
16	Optum fee schedule · outpatient · +4 other terms	33	$400	$437	$151	35%	—	$306 – $780
17	Caresource fee schedule · outpatient · +5 other terms	28	$312	$337	$94	28%	—	$175 – $490
18	Medica facility · fee schedule · outpatient · +5 other terms	22	$324	$304	$83	27%	—	$106 – $526
19	Regence facility · fee schedule · outpatient · +4 other terms	19	$433	$410	$39	10%	—	$321 – $441
20	Amerihealth Caritas fee schedule · outpatient · +1 other terms	18	$374	$365	$18	5%	—	$318 – $374
21	Bcbs Tx fee schedule · outpatient	18	$306	$306	—	—	—	$306 – $306
22	Medicare fee schedule · outpatient · +3 other terms	18	$400	$401	$3	1%	—	$400 – $408
23	Tricare facility · fee schedule · outpatient · +2 other terms	16	$312	$346	$47	14%	—	$306 – $416
24	Medical Mutual facility · fee schedule · outpatient · +2 other terms	15	$317	$367	$91	25%	—	$173 – $501
25	Highmark facility · fee schedule · outpatient · +4 other terms	14	$577	$583	$252	43%	—	$300 – $1.1k

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