Lower extremity prosthesis shoulder harness

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

Shoulder harness

Payers reporting HCPCS L5699

Payer pricing summary

Low

$79

Average

$300

Median

$284

High

$655

Payer rate distribution

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#
1	Aetna fee schedule · outpatient · +10 other terms	359	$254	$304	$176	58%	—	$139 – $2.2k
2	UnitedHealthcare fee schedule · outpatient · +11 other terms	356	$242	$259	$79	30%	—	$112 – $998
3	Humana fee schedule · outpatient · +12 other terms	317	$285	$373	$367	98%	—	$128 – $1.8k
4	Blue Cross Blue Shield fee schedule · outpatient · +10 other terms	218	$295	$347	$182	52%	—	$0 – $1.1k
5	WellCare fee schedule · outpatient · +4 other terms	208	$242	$261	$47	18%	—	$224 – $454
6	Devoted fee schedule · outpatient · +3 other terms	165	$228	$244	$28	11%	—	$219 – $310
7	Molina fee schedule · outpatient · +5 other terms	138	$336	$334	$125	37%	—	$135 – $602
8	Cigna Healthspring fee schedule · outpatient · +2 other terms	116	$237	$248	$34	14%	—	$228 – $313
9	Cigna fee schedule · outpatient · +9 other terms	102	$298	$296	$84	28%	—	$219 – $736
10	Anthem fee schedule · outpatient · +6 other terms	81	$228	$341	$333	98%	—	$128 – $1.9k
11	Kaiser fee schedule · outpatient · +6 other terms	64	$233	$458	$370	81%	—	$219 – $2.2k
12	Ambetter facility · fee schedule · outpatient · +6 other terms	46	$432	$493	$144	29%	—	$284 – $724
13	Superior Healthplan fee schedule · outpatient · +1 other terms	40	$240	$240	$1	0%	—	$224 – $240
14	Clover fee schedule · outpatient · +2 other terms	37	$240	$256	$33	13%	—	$228 – $304
15	Oscar fee schedule · outpatient · +4 other terms	36	$300	$302	$93	31%	—	$224 – $517
16	Optum fee schedule · outpatient · +2 other terms	33	$290	$312	$115	37%	—	$219 – $571
17	Caresource fee schedule · outpatient · +5 other terms	28	$290	$288	$74	26%	—	$128 – $388
18	Regence facility · fee schedule · outpatient · +4 other terms	19	$237	$249	$18	7%	—	$228 – $288
19	Amerihealth Caritas fee schedule · outpatient · +1 other terms	18	$347	$332	$36	11%	—	$233 – $347
20	Bcbs Tx fee schedule · outpatient	18	$224	$224	—	—	—	$224 – $224
21	Medicare fee schedule · outpatient · +3 other terms	18	$219	$220	$2	1%	—	$219 – $224
22	Medical Mutual facility · fee schedule · outpatient · +2 other terms	15	$251	$290	$72	25%	—	$137 – $397
23	Tricare facility · fee schedule · outpatient · +2 other terms	15	$228	$230	$15	7%	—	$210 – $284
24	Highmark facility · fee schedule · outpatient · +4 other terms	14	$410	$399	$163	41%	—	$219 – $650
25	Bcbs Mn fee schedule · outpatient · +4 other terms	13	$228	$228	$53	23%	—	$111 – $267

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