Latex suspension sleeve for upper limb prosthesis

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

Latex suspension sleeve each

Payers reporting HCPCS L6632

Payer pricing summary

Low

$21

Average

$108

Median

$93

High

$358

Payer rate distribution

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#
1	Aetna fee schedule · outpatient · +12 other terms	359	$89	$100	$44	44%	—	$44 – $532
2	UnitedHealthcare fee schedule · outpatient · +13 other terms	356	$89	$88	$21	23%	—	$34 – $264
3	Humana fee schedule · outpatient · +12 other terms	317	$91	$127	$126	99%	—	$42 – $612
4	Blue Cross Blue Shield fee schedule · outpatient · +11 other terms	218	$92	$111	$57	51%	—	$0 – $412
5	WellCare fee schedule · outpatient · +5 other terms	208	$84	$88	$14	16%	—	$77 – $155
6	Devoted fee schedule · outpatient · +3 other terms	165	$92	$86	$9	10%	—	$80 – $108
7	Molina fee schedule · outpatient · +5 other terms	138	$117	$112	$42	38%	—	$48 – $212
8	Cigna Healthspring fee schedule · outpatient · +1 other terms	116	$94	$86	$9	11%	—	$80 – $109
9	Cigna fee schedule · outpatient · +11 other terms	102	$96	$103	$25	24%	—	$78 – $233
10	Anthem fee schedule · outpatient · +6 other terms	80	$104	$122	$102	84%	—	$46 – $597
11	Kaiser fee schedule · outpatient · +6 other terms	64	$108	$142	$87	61%	—	$80 – $584
12	Superior Healthplan fee schedule · outpatient	40	$84	$83	$0	0%	—	$78 – $84
13	Clover fee schedule · outpatient · +3 other terms	37	$84	$85	$8	10%	—	$78 – $106
14	Oscar fee schedule · outpatient · +4 other terms	36	$96	$97	$22	23%	—	$78 – $154
15	Ambetter facility · fee schedule · outpatient · +6 other terms	35	$143	$164	$46	28%	—	$84 – $229
16	Optum fee schedule · outpatient · +3 other terms	33	$102	$115	$36	31%	—	$77 – $199
17	Caresource fee schedule · outpatient · +5 other terms	29	$92	$90	$24	26%	—	$46 – $123
18	Medica facility · fee schedule · outpatient · +5 other terms	22	$81	$77	$22	29%	—	$27 – $146
19	Regence facility · fee schedule · outpatient · +4 other terms	19	$110	$100	$17	17%	—	$66 – $112
20	Amerihealth Caritas fee schedule · outpatient · +1 other terms	18	$110	$107	$6	6%	—	$90 – $110
21	Bcbs Tx fee schedule · outpatient	18	$78	$78	—	—	—	$78 – $78
22	Medicare fee schedule · outpatient · +3 other terms	18	$102	$102	$1	1%	—	$102 – $104
23	Medical Mutual facility · fee schedule · outpatient · +2 other terms	15	$80	$92	$23	25%	—	$43 – $126
24	Bcbs Mn fee schedule · outpatient · +6 other terms	13	$72	$72	$17	23%	—	$35 – $85
25	Wellmark fee schedule · both · +3 other terms	13	$84	$84	$4	5%	—	$58 – $84

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