Prosthetic gel sheath or sock for below or above knee 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

Pros sheath/sock w gel cushn

Payers reporting HCPCS L8417

Payer pricing summary

Low

$23

Average

$130

Median

$106

High

$470

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	Aetna fee schedule · outpatient · +16 other terms	361	$94	$107	$50	47%	—	$45 – $604
2	UnitedHealthcare fee schedule · outpatient · +17 other terms	358	$94	$98	$75	76%	—	$32 – $1.3k
3	Humana fee schedule · outpatient · +14 other terms	318	$93	$139	$149	107%	—	$48 – $716
4	Blue Cross Blue Shield fee schedule · outpatient · +12 other terms	220	$95	$125	$98	78%	—	$0 – $1.8k
5	WellCare fee schedule · outpatient · +5 other terms	208	$96	$98	$15	15%	—	$88 – $176
6	Devoted fee schedule · outpatient · +5 other terms	165	$93	$94	$2	2%	—	$90 – $112
7	Molina fee schedule · outpatient · +8 other terms	140	$132	$127	$49	38%	—	$32 – $244
8	Cigna Healthspring fee schedule · outpatient · +1 other terms	116	$95	$95	$3	3%	—	$93 – $114
9	Cigna fee schedule · outpatient · +14 other terms	105	$96	$122	$137	112%	—	$58 – $1.2k
10	Anthem fee schedule · outpatient · +14 other terms	80	$92	$155	$186	120%	—	$78 – $927
11	Kaiser fee schedule · outpatient · +8 other terms	65	$95	$154	$116	75%	—	$90 – $663
12	Superior Healthplan fee schedule · outpatient · +1 other terms	40	$98	$98	$0	0%	—	$91 – $98
13	Ambetter facility · fee schedule · outpatient · +7 other terms	37	$164	$171	$44	26%	—	$67 – $233
14	Clover fee schedule · outpatient · +3 other terms	37	$93	$94	$5	5%	—	$88 – $110
15	Oscar fee schedule · outpatient · +6 other terms	36	$98	$107	$23	21%	—	$91 – $157
16	Optum fee schedule · outpatient · +6 other terms	33	$93	$122	$49	41%	—	$89 – $233
17	Caresource fee schedule · outpatient · +5 other terms	26	$93	$106	$21	20%	—	$93 – $143
18	Medica facility · fee schedule · outpatient · +5 other terms	23	$95	$87	$22	26%	—	$31 – $154
19	Regence facility · fee schedule · outpatient · +4 other terms	19	$97	$93	$7	8%	—	$75 – $99
20	Amerihealth Caritas fee schedule · outpatient · +2 other terms	18	$112	$109	$6	6%	—	$92 – $112
21	Bcbs Tx fee schedule · outpatient	18	$91	$91	—	—	—	$91 – $91
22	Medicare fee schedule · outpatient · +4 other terms	18	$90	$90	$1	1%	—	$90 – $92
23	Medical Mutual facility · fee schedule · outpatient · +2 other terms	15	$93	$107	$26	25%	—	$50 – $146
24	Bcbs Mn fee schedule · outpatient · +6 other terms	13	$84	$84	$20	23%	—	$41 – $99
25	Wellmark fee schedule · both · +3 other terms	13	$89	$88	$3	4%	—	$67 – $89

Page 1 of 3 · 54 payers