Below-knee prosthetic leg addition, ultra-light material

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

HB Add,Ultra-Lite,Bk Endo

Payers reporting HCPCS L5940

Payer pricing summary

Low

$169

Average

$858

Median

$803

High

$1.8k

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +20 other terms	369	$802	$724	$251	35%	—	$235 – $2.5k
2	Aetna fee schedule · outpatient · +18 other terms	363	$768	$836	$418	50%	—	$294 – $5.1k
3	Humana fee schedule · outpatient · +17 other terms	320	$694	$1.1k	$1.3k	120%	—	$321 – $6.3k
4	Blue Cross Blue Shield fee schedule · outpatient · +16 other terms	236	$803	$920	$469	51%	—	$0 – $3.9k
5	WellCare fee schedule · outpatient · +10 other terms	208	$803	$799	$133	17%	—	$592 – $1.3k
6	Devoted fee schedule · outpatient · +4 other terms	165	$814	$774	$85	11%	—	$614 – $876
7	Molina fee schedule · outpatient · +10 other terms	144	$960	$1.1k	$437	41%	—	$375 – $2.1k
8	Cigna Healthspring fee schedule · outpatient · +2 other terms	116	$657	$771	$78	10%	—	$614 – $843
9	Cigna fee schedule · outpatient · +17 other terms	115	$803	$917	$358	39%	—	$429 – $2.1k
10	Anthem fee schedule · outpatient · +12 other terms	88	$803	$934	$749	80%	—	$353 – $4.6k
11	Kaiser fee schedule · outpatient · +12 other terms	70	$835	$1.2k	$834	70%	—	$446 – $5.6k
12	Ambetter facility · fee schedule · outpatient · +7 other terms	45	$1.0k	$1.1k	$263	23%	—	$446 – $1.5k
13	Superior Healthplan fee schedule · outpatient	40	$860	$859	$4	0%	—	$803 – $860
14	Clover fee schedule · outpatient · +3 other terms	37	$654	$694	$87	13%	—	$614 – $860
15	Oscar fee schedule · outpatient · +7 other terms	36	$802	$837	$187	22%	—	$645 – $1.4k
16	Optum fee schedule · outpatient · +4 other terms	33	$787	$1.0k	$482	48%	—	$592 – $2.0k
17	Caresource fee schedule · outpatient · +5 other terms	29	$614	$640	$189	30%	—	$336 – $949
18	Medica facility · fee schedule · outpatient · +5 other terms	22	$628	$598	$188	32%	—	$205 – $1.4k
19	Regence facility · fee schedule · outpatient · +4 other terms	19	$852	$810	$75	9%	—	$636 – $868
20	Amerihealth Caritas fee schedule · outpatient · +2 other terms	18	$737	$719	$35	5%	—	$626 – $737
21	Bcbs Tx fee schedule · outpatient	18	$803	$803	—	—	—	$803 – $803
22	Medicare fee schedule · outpatient · +3 other terms	18	$787	$790	$6	1%	—	$787 – $803
23	Tricare facility · fee schedule · outpatient · +2 other terms	16	$614	$645	$64	10%	—	$600 – $803
24	Medical Mutual facility · fee schedule · outpatient · +2 other terms	15	$614	$711	$176	25%	—	$334 – $970
25	Highmark facility · fee schedule · outpatient · +5 other terms	14	$1.1k	$1.1k	$443	41%	—	$590 – $1.8k

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