Shoulder universal joint for upper extremity orthosis add-on

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

IMMOBILIZER SHLDR UNIV CU

Payers reporting HCPCS L6650

Payer pricing summary

Low

$143

Average

$575

Median

$513

High

$1.3k

Payer rate distribution

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#
1	Aetna fee schedule · outpatient · +12 other terms	359	$515	$550	$252	46%	—	$244 – $3.2k
2	UnitedHealthcare fee schedule · outpatient · +14 other terms	356	$513	$478	$117	25%	—	$203 – $1.4k
3	Humana fee schedule · outpatient · +12 other terms	317	$508	$751	$840	112%	—	$250 – $4.0k
4	Blue Cross Blue Shield fee schedule · outpatient · +10 other terms	219	$520	$653	$338	52%	—	$0 – $2.5k
5	WellCare fee schedule · outpatient · +4 other terms	208	$533	$533	$80	15%	—	$423 – $926
6	Devoted fee schedule · outpatient · +3 other terms	165	$510	$505	$39	8%	—	$398 – $563
7	Molina fee schedule · outpatient · +5 other terms	138	$670	$692	$268	39%	—	$265 – $1.4k
8	Cigna Healthspring fee schedule · outpatient · +1 other terms	116	$525	$513	$36	7%	—	$414 – $569
9	Cigna fee schedule · outpatient · +9 other terms	102	$525	$530	$150	28%	—	$398 – $1.4k
10	Anthem fee schedule · outpatient · +6 other terms	80	$414	$625	$655	105%	—	$250 – $3.6k
11	Kaiser fee schedule · outpatient · +6 other terms	64	$423	$712	$503	71%	—	$398 – $3.1k
12	Superior Healthplan fee schedule · outpatient	40	$544	$543	$3	0%	—	$508 – $544
13	Clover fee schedule · outpatient · +2 other terms	37	$510	$504	$35	7%	—	$465 – $553
14	Oscar fee schedule · outpatient · +4 other terms	36	$536	$595	$143	24%	—	$497 – $939
15	Ambetter facility · fee schedule · outpatient · +6 other terms	35	$875	$955	$224	23%	—	$443 – $1.3k
16	Optum fee schedule · outpatient · +2 other terms	33	$510	$631	$305	48%	—	$398 – $1.3k
17	Caresource fee schedule · outpatient · +6 other terms	29	$510	$513	$152	30%	—	$250 – $752
18	Medica facility · fee schedule · outpatient · +5 other terms	22	$497	$448	$112	25%	—	$162 – $690
19	Regence facility · fee schedule · outpatient · +4 other terms	19	$431	$418	$26	6%	—	$349 – $439
20	Amerihealth Caritas fee schedule · outpatient · +1 other terms	18	$612	$586	$59	10%	—	$423 – $612
21	Bcbs Tx fee schedule · outpatient	18	$508	$508	—	—	—	$508 – $508
22	Medicare fee schedule · outpatient · +4 other terms	18	$398	$400	$3	1%	—	$398 – $406
23	Medical Mutual facility · fee schedule · outpatient · +2 other terms	15	$486	$559	$138	25%	—	$265 – $768
24	Bcbs Mn fee schedule · outpatient · +6 other terms	13	$442	$442	$103	23%	—	$215 – $518
25	Wellmark fee schedule · both · +3 other terms	13	$398	$397	$7	2%	—	$354 – $398

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