Prosthetic addition for above-knee leg, silesian bandage

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

Silesian Belt

Payers reporting HCPCS L5698

Payer pricing summary

Low

$44

Average

$205

Median

$169

High

$566

Payer rate distribution

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#
1	Aetna fee schedule · outpatient · +14 other terms	361	$157	$173	$85	49%	—	$77 – $1.0k
2	UnitedHealthcare fee schedule · outpatient · +16 other terms	358	$150	$148	$41	27%	—	$62 – $508
3	Humana fee schedule · outpatient · +16 other terms	319	$158	$224	$236	105%	—	$77 – $1.1k
4	Blue Cross Blue Shield fee schedule · outpatient · +14 other terms	219	$164	$201	$103	51%	—	$0 – $706
5	WellCare fee schedule · outpatient · +6 other terms	208	$152	$159	$30	19%	—	$132 – $313
6	Devoted fee schedule · outpatient · +4 other terms	165	$147	$148	$11	7%	—	$123 – $174
7	Molina fee schedule · outpatient · +6 other terms	140	$216	$202	$76	38%	—	$81 – $384
8	Cigna Healthspring fee schedule · outpatient · +2 other terms	116	$149	$151	$13	8%	—	$128 – $175
9	Cigna fee schedule · outpatient · +12 other terms	104	$162	$166	$48	29%	—	$103 – $431
10	Anthem fee schedule · outpatient · +11 other terms	80	$128	$192	$197	103%	—	$82 – $1.1k
11	Kaiser fee schedule · outpatient · +7 other terms	64	$130	$241	$186	77%	—	$123 – $1.1k
12	Ambetter facility · fee schedule · outpatient · +6 other terms	46	$238	$278	$76	27%	—	$144 – $402
13	Superior Healthplan fee schedule · outpatient	40	$154	$154	$1	0%	—	$144 – $154
14	Clover fee schedule · outpatient · +3 other terms	37	$157	$160	$6	3%	—	$154 – $170
15	Oscar fee schedule · outpatient · +6 other terms	36	$169	$179	$46	26%	—	$144 – $286
16	Optum fee schedule · outpatient · +4 other terms	33	$161	$188	$81	43%	—	$123 – $366
17	Caresource fee schedule · outpatient · +7 other terms	28	$161	$164	$41	25%	—	$82 – $227
18	Medica facility · fee schedule · outpatient · +7 other terms	22	$150	$136	$36	26%	—	$49 – $237
19	Amerihealth Caritas fee schedule · outpatient · +1 other terms	18	$193	$184	$19	10%	—	$131 – $193
20	Bcbs Tx fee schedule · outpatient	18	$144	$144	—	—	—	$144 – $144
21	Medicare fee schedule · outpatient · +3 other terms	18	$123	$123	$1	1%	—	$123 – $125
22	Regence facility · fee schedule · outpatient · +6 other terms	17	$133	$134	$5	4%	—	$128 – $147
23	Medical Mutual facility · fee schedule · outpatient · +2 other terms	15	$147	$169	$42	25%	—	$80 – $232
24	Tricare facility · fee schedule · outpatient · +3 other terms	15	$129	$137	$14	10%	—	$125 – $160
25	Highmark facility · fee schedule · outpatient · +6 other terms	14	$236	$237	$99	42%	—	$124 – $421

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