Repair of maxillofacial 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

Repair maxillofacial prosth

Payers reporting HCPCS L8049

Payer pricing summary

Low

Average

$32

Median

$22

High

$169

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	Humana fee schedule · outpatient · +4 other terms	38	$198	$214	$76	36%	—	$16 – $270
2	Blue Cross Blue Shield facility · fee schedule · outpatient · +7 other terms	35	$41	$45	$28	61%	—	$0 – $128
3	UnitedHealthcare fee schedule · both · +8 other terms	26	$13	$24	$14	57%	—	$13 – $57
4	Aetna fee schedule · outpatient · +6 other terms	19	$28	$64	$48	75%	—	$28 – $182
5	Anthem facility · fee schedule · outpatient · +5 other terms	17	$16	$20	$8	40%	—	$8 – $37
6	Caresource facility · case rate · outpatient · +3 other terms	16	$16	$17	$4	22%	—	$10 – $27
7	Molina facility · case rate · outpatient · +3 other terms	15	$15	$17	$4	23%	—	$11 – $26
8	Wellmark fee schedule · both · +1 other terms	13	$32	$31	$3	10%	—	$12 – $32
9	Bcbs Mn fee schedule · outpatient · +3 other terms	12	$50	$37	$21	57%	—	$16 – $62
10	Optum facility · case rate · outpatient · +1 other terms	11	$14	$16	$4	22%	—	$13 – $24
11	Highmark fee schedule · outpatient · +1 other terms	10	$17	$17	—	—	—	$17 – $17
12	Medica fee schedule · both · +1 other terms	9	$16	$16	—	—	—	$16 – $16
13	Ucare fee schedule · both · +3 other terms	9	$17	$17	—	—	—	$17 – $17
14	Cigna professional · fee schedule · outpatient · +3 other terms	8	$11	$11	—	—	—	$11 – $11
15	Aetna Better Health fee schedule · inpatient · +1 other terms	7	$29	$29	—	—	—	$29 – $29
16	Amerihealth Caritas professional · fee schedule · outpatient	3	$20	$20	$1	3%	—	$19 – $21
17	First Health professional · fee schedule · both	3	$31	$31	—	—	—	$31 – $31
18	MultiPlan professional · percent of total billed charges · bothfrom % of charges · +1 other terms	3	$13	$42	$42	99%	—	$13 – $101
19	Bcbs Id professional · fee schedule · outpatient	1	$23	$23	—	—	—	$23 – $23
20	Bcbs Il professional · fee schedule · both	1	$28	$28	—	—	—	$28 – $28
21	Bcbs La facility · fee schedule · outpatient	1	$0	$0	—	—	—	$0 – $0
22	Bcbs Nc facility · fee schedule · outpatient	1	$21	$21	—	—	—	$21 – $21
23	Bcbs Nv fee schedule · outpatient	1	$14	$14	—	—	—	$14 – $14
24	Bcbs Vt professional · fee schedule · outpatient	1	$50	$50	—	—	—	$50 – $50
25	Magellan fee schedule · outpatient	1	$22	$22	—	—	—	$22 – $22