Extra standard control cable for upper extremity prosthetic

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

Standard control cable extra

Payers reporting HCPCS L6655

Payer pricing summary

Low

$32

Average

$129

Median

$115

High

$374

Payer rate distribution

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#
1	Aetna fee schedule · outpatient · +12 other terms	361	$103	$123	$70	57%	—	$48 – $820
2	UnitedHealthcare fee schedule · outpatient · +13 other terms	358	$101	$103	$32	31%	—	$37 – $407
3	Humana fee schedule · outpatient · +12 other terms	319	$100	$161	$184	115%	—	$49 – $872
4	Blue Cross Blue Shield fee schedule · outpatient · +11 other terms	219	$111	$143	$74	52%	—	$0 – $546
5	WellCare fee schedule · outpatient · +5 other terms	208	$111	$115	$16	14%	—	$91 – $191
6	Devoted fee schedule · outpatient · +3 other terms	165	$100	$108	$8	8%	—	$88 – $125
7	Molina fee schedule · outpatient · +5 other terms	140	$147	$154	$60	39%	—	$49 – $297
8	Cigna Healthspring fee schedule · outpatient · +1 other terms	116	$107	$110	$7	6%	—	$92 – $126
9	Cigna fee schedule · outpatient · +12 other terms	102	$108	$117	$33	28%	—	$88 – $277
10	Anthem fee schedule · outpatient · +6 other terms	80	$92	$130	$125	96%	—	$54 – $708
11	Kaiser fee schedule · outpatient · +6 other terms	64	$94	$186	$151	81%	—	$88 – $900
12	Superior Healthplan fee schedule · outpatient	40	$119	$119	$1	0%	—	$111 – $119
13	Clover fee schedule · outpatient · +3 other terms	37	$100	$104	$9	9%	—	$96 – $123
14	Ambetter facility · fee schedule · outpatient · +6 other terms	36	$174	$190	$43	23%	—	$68 – $251
15	Oscar fee schedule · outpatient · +6 other terms	36	$111	$127	$34	27%	—	$104 – $208
16	Optum fee schedule · outpatient · +3 other terms	33	$100	$137	$67	49%	—	$88 – $283
17	Caresource fee schedule · outpatient · +5 other terms	29	$100	$101	$28	28%	—	$54 – $146
18	Medica facility · fee schedule · outpatient · +5 other terms	22	$96	$89	$25	28%	—	$31 – $183
19	Regence facility · fee schedule · outpatient · +4 other terms	19	$96	$101	$8	8%	—	$92 – $117
20	Amerihealth Caritas fee schedule · outpatient · +1 other terms	18	$120	$116	$8	7%	—	$94 – $120
21	Bcbs Tx fee schedule · outpatient	18	$111	$111	—	—	—	$111 – $111
22	Medicare fee schedule · outpatient · +3 other terms	18	$88	$89	$1	1%	—	$88 – $90
23	Medical Mutual facility · fee schedule · outpatient · +2 other terms	15	$94	$109	$27	25%	—	$51 – $149
24	Bcbs Mn fee schedule · outpatient · +6 other terms	13	$86	$86	$20	23%	—	$42 – $100
25	Wellmark fee schedule · both · +4 other terms	13	$106	$105	$6	6%	—	$69 – $106

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