Prosthetic arm sheath (per unit)

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

Sheath upper limb

Payers reporting HCPCS L8415

Payer pricing summary

Low

Average

$43

Median

$31

High

$320

Payer rate distribution

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#
1	Aetna fee schedule · outpatient · +12 other terms	361	$28	$34	$18	53%	—	$13 – $222
2	UnitedHealthcare fee schedule · outpatient · +13 other terms	357	$28	$29	$8	28%	—	$12 – $110
3	Humana fee schedule · outpatient · +12 other terms	318	$28	$42	$46	109%	—	$14 – $220
4	Blue Cross Blue Shield fee schedule · outpatient · +11 other terms	219	$29	$37	$20	53%	—	$0 – $137
5	WellCare fee schedule · outpatient · +5 other terms	208	$30	$30	$5	18%	—	$25 – $57
6	Devoted fee schedule · outpatient · +3 other terms	165	$29	$28	$1	4%	—	$26 – $36
7	Molina fee schedule · outpatient · +5 other terms	139	$41	$40	$15	38%	—	$19 – $75
8	Cigna Healthspring fee schedule · outpatient · +1 other terms	116	$29	$29	$1	4%	—	$26 – $36
9	Cigna fee schedule · outpatient · +11 other terms	102	$28	$33	$9	29%	—	$26 – $77
10	Anthem fee schedule · outpatient · +6 other terms	79	$29	$38	$34	90%	—	$26 – $197
11	Kaiser fee schedule · outpatient · +6 other terms	64	$30	$51	$40	77%	—	$28 – $244
12	Superior Healthplan fee schedule · outpatient	40	$30	$30	$0	0%	—	$28 – $30
13	Clover fee schedule · outpatient · +3 other terms	37	$29	$29	$1	5%	—	$26 – $35
14	Oscar fee schedule · outpatient · +4 other terms	36	$28	$33	$8	25%	—	$28 – $51
15	Ambetter facility · fee schedule · outpatient · +6 other terms	35	$47	$51	$10	20%	—	$26 – $74
16	Optum fee schedule · outpatient · +3 other terms	33	$28	$37	$15	42%	—	$25 – $72
17	Caresource fee schedule · outpatient · +5 other terms	26	$26	$30	$6	20%	—	$26 – $41
18	Medica facility · fee schedule · outpatient · +5 other terms	22	$27	$25	$7	28%	—	$9 – $50
19	Regence facility · fee schedule · outpatient · +4 other terms	19	$30	$30	$1	3%	—	$28 – $32
20	Amerihealth Caritas fee schedule · outpatient · +1 other terms	18	$31	$31	$1	3%	—	$28 – $31
21	Bcbs Tx fee schedule · outpatient	18	$28	$28	—	—	—	$28 – $28
22	Medicare fee schedule · outpatient · +3 other terms	18	$28	$28	$0	1%	—	$28 – $28
23	Medical Mutual facility · fee schedule · outpatient · +2 other terms	15	$26	$30	$8	25%	—	$14 – $41
24	Bcbs Mn fee schedule · outpatient · +6 other terms	13	$24	$24	$6	23%	—	$12 – $28
25	Wellmark fee schedule · both · +3 other terms	13	$29	$28	$2	5%	—	$19 – $29

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