Below-knee prosthetic back check addition

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 back check

Payers reporting HCPCS L5686

Payer pricing summary

Low

$20

Average

$86

Median

$75

High

$201

Payer rate distribution

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#
1	Aetna fee schedule · outpatient · +11 other terms	361	$71	$83	$45	54%	—	$30 – $522
2	UnitedHealthcare fee schedule · outpatient · +13 other terms	358	$67	$71	$19	26%	—	$31 – $259
3	Humana fee schedule · outpatient · +10 other terms	319	$70	$100	$106	105%	—	$37 – $509
4	Blue Cross Blue Shield fee schedule · outpatient · +9 other terms	219	$66	$91	$53	58%	—	$0 – $372
5	WellCare fee schedule · outpatient · +4 other terms	208	$68	$72	$17	24%	—	$61 – $163
6	Devoted fee schedule · outpatient · +3 other terms	165	$66	$67	$3	5%	—	$63 – $85
7	Molina fee schedule · outpatient · +5 other terms	140	$97	$94	$35	37%	—	$44 – $173
8	Cigna Healthspring fee schedule · outpatient · +2 other terms	116	$67	$68	$5	7%	—	$63 – $86
9	Cigna fee schedule · outpatient · +9 other terms	102	$71	$81	$28	34%	—	$61 – $209
10	Anthem fee schedule · outpatient · +6 other terms	80	$74	$98	$93	95%	—	$41 – $532
11	Kaiser fee schedule · outpatient · +6 other terms	64	$75	$125	$92	74%	—	$71 – $573
12	Ambetter facility · fee schedule · outpatient · +6 other terms	46	$115	$124	$21	17%	—	$61 – $156
13	Superior Healthplan fee schedule · outpatient	40	$69	$69	$0	0%	—	$65 – $69
14	Clover fee schedule · outpatient · +2 other terms	37	$82	$74	$8	11%	—	$63 – $83
15	Oscar fee schedule · outpatient · +4 other terms	36	$66	$78	$22	28%	—	$65 – $129
16	Optum fee schedule · outpatient · +2 other terms	33	$71	$89	$33	37%	—	$63 – $165
17	Caresource fee schedule · outpatient · +5 other terms	28	$63	$71	$22	31%	—	$41 – $110
18	Medica facility · fee schedule · outpatient · +5 other terms	22	$72	$67	$17	26%	—	$24 – $112
19	Regence facility · fee schedule · outpatient · +4 other terms	19	$77	$75	$3	5%	—	$65 – $78
20	Amerihealth Caritas fee schedule · outpatient · +1 other terms	18	$75	$75	$3	3%	—	$71 – $81
21	Bcbs Tx fee schedule · outpatient	18	$65	$65	—	—	—	$65 – $65
22	Medicare fee schedule · outpatient · +1 other terms	18	$71	$71	$1	1%	—	$71 – $72
23	Medical Mutual facility · fee schedule · outpatient · +2 other terms	15	$71	$82	$20	25%	—	$39 – $112
24	Tricare facility · fee schedule · outpatient · +2 other terms	15	$79	$78	$5	7%	—	$61 – $83
25	Highmark facility · fee schedule · outpatient · +4 other terms	14	$145	$141	$58	41%	—	$76 – $226

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