Ultralight shoulder prosthesis add-on part

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

Add ue prost s/d ultlite mat

Payers reporting HCPCS L7402

Payer pricing summary

Low

$116

Average

$526

Median

$479

High

$1.0k

Payer rate distribution

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#
1	Aetna fee schedule · outpatient · +9 other terms	361	$461	$528	$245	46%	—	$220 – $3.0k
2	UnitedHealthcare fee schedule · outpatient · +11 other terms	358	$461	$462	$106	23%	—	$199 – $1.5k
3	Humana fee schedule · outpatient · +9 other terms	319	$457	$684	$734	107%	—	$238 – $3.5k
4	Blue Cross Blue Shield fee schedule · outpatient · +8 other terms	219	$468	$599	$313	52%	—	$0 – $2.2k
5	WellCare fee schedule · outpatient · +4 other terms	208	$472	$485	$72	15%	—	$437 – $869
6	Devoted fee schedule · outpatient · +3 other terms	165	$459	$461	$11	2%	—	$443 – $554
7	Molina fee schedule · outpatient · +4 other terms	140	$651	$628	$236	38%	—	$309 – $1.2k
8	Cigna Healthspring fee schedule · outpatient · +2 other terms	116	$468	$467	$16	3%	—	$459 – $559
9	Cigna fee schedule · outpatient · +5 other terms	104	$472	$519	$144	28%	—	$286 – $1.3k
10	Anthem fee schedule · outpatient · +6 other terms	80	$452	$623	$604	97%	—	$299 – $3.4k
11	Kaiser fee schedule · outpatient · +3 other terms	64	$470	$733	$514	70%	—	$443 – $3.3k
12	Ambetter facility · fee schedule · outpatient · +5 other terms	45	$684	$817	$204	25%	—	$437 – $1.1k
13	Superior Healthplan fee schedule · outpatient	40	$482	$481	$2	0%	—	$450 – $482
14	Clover fee schedule · outpatient · +2 other terms	37	$459	$462	$24	5%	—	$437 – $543
15	Oscar fee schedule · outpatient · +3 other terms	36	$482	$529	$112	21%	—	$450 – $772
16	Optum fee schedule · outpatient · +2 other terms	33	$459	$599	$243	41%	—	$440 – $1.1k
17	Caresource fee schedule · outpatient · +4 other terms	28	$459	$494	$122	25%	—	$299 – $705
18	Regence facility · fee schedule · outpatient · +3 other terms	19	$480	$460	$36	8%	—	$371 – $489
19	Amerihealth Caritas fee schedule · outpatient · +1 other terms	18	$550	$535	$30	6%	—	$454 – $550
20	Bcbs Tx fee schedule · outpatient	18	$450	$450	—	—	—	$450 – $450
21	Medicare fee schedule · outpatient · +1 other terms	18	$443	$445	$3	1%	—	$443 – $452
22	Medical Mutual facility · fee schedule · outpatient · +1 other terms	15	$456	$526	$130	25%	—	$248 – $721
23	Tricare facility · fee schedule · outpatient · +2 other terms	15	$445	$442	$12	3%	—	$401 – $452
24	Highmark facility · fee schedule · outpatient · +4 other terms	14	$770	$764	$314	41%	—	$428 – $1.3k
25	Bcbs Mn fee schedule · outpatient · +4 other terms	13	$415	$415	$97	23%	—	$202 – $486

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