Below-knee prosthetic leg addition with removable medial brim suspension

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

Bk removable medial brim sus

Payers reporting HCPCS L5672

Payer pricing summary

Low

$100

Average

$481

Median

$437

High

$1.0k

Payer rate distribution

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#
1	Aetna fee schedule · outpatient · +11 other terms	359	$376	$463	$229	49%	—	$175 – $2.6k
2	UnitedHealthcare fee schedule · outpatient · +13 other terms	356	$372	$404	$100	25%	—	$179 – $1.3k
3	Humana fee schedule · outpatient · +10 other terms	317	$380	$566	$582	103%	—	$230 – $2.8k
4	Blue Cross Blue Shield fee schedule · outpatient · +10 other terms	218	$372	$510	$305	60%	—	$0 – $2.2k
5	WellCare fee schedule · outpatient · +5 other terms	208	$383	$396	$65	16%	—	$358 – $712
6	Devoted fee schedule · outpatient · +3 other terms	165	$365	$381	$36	10%	—	$365 – $496
7	Molina fee schedule · outpatient · +5 other terms	138	$538	$527	$198	38%	—	$302 – $973
8	Cigna Healthspring fee schedule · outpatient · +2 other terms	116	$391	$387	$40	10%	—	$365 – $501
9	Cigna fee schedule · outpatient · +11 other terms	102	$419	$471	$156	33%	—	$358 – $1.3k
10	Anthem fee schedule · outpatient · +6 other terms	80	$477	$609	$580	95%	—	$285 – $3.3k
11	Kaiser fee schedule · outpatient · +6 other terms	64	$496	$683	$438	64%	—	$395 – $2.9k
12	Ambetter facility · fee schedule · outpatient · +6 other terms	46	$671	$707	$143	20%	—	$358 – $913
13	Superior Healthplan fee schedule · outpatient	40	$383	$383	$2	0%	—	$358 – $383
14	Clover fee schedule · outpatient · +3 other terms	37	$365	$373	$21	6%	—	$358 – $487
15	Oscar fee schedule · outpatient · +4 other terms	36	$383	$433	$105	24%	—	$358 – $656
16	Optum fee schedule · outpatient · +3 other terms	33	$468	$524	$169	32%	—	$365 – $913
17	Caresource fee schedule · outpatient · +5 other terms	28	$365	$431	$135	31%	—	$285 – $679
18	Medica facility · fee schedule · outpatient · +5 other terms	22	$450	$413	$103	25%	—	$147 – $629
19	Regence facility · fee schedule · outpatient · +4 other terms	19	$506	$466	$68	15%	—	$329 – $516
20	Amerihealth Caritas fee schedule · outpatient · +1 other terms	18	$438	$438	$14	3%	—	$416 – $472
21	Bcbs Tx fee schedule · outpatient	18	$358	$358	—	—	—	$358 – $358
22	Medicare fee schedule · outpatient · +1 other terms	18	$468	$469	$4	1%	—	$468 – $477
23	Medical Mutual facility · fee schedule · outpatient · +2 other terms	15	$440	$505	$125	25%	—	$239 – $695
24	Highmark facility · fee schedule · outpatient · +4 other terms	14	$805	$761	$327	43%	—	$365 – $1.3k
25	Tricare facility · fee schedule · outpatient · +2 other terms	14	$458	$425	$53	12%	—	$329 – $477

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