Shoulder cast supplies, adult, fiberglass

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

Cast sup shoulder cast fbrgl

Payers reporting HCPCS Q4004

Payer pricing summary

Low

$53

Average

$171

Median

$155

High

$436

Payer rate distribution

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#
1	Humana fee schedule · outpatient · +14 other terms	301	$155	$236	$248	105%	—	$71 – $1.2k
2	UnitedHealthcare fee schedule · outpatient · +16 other terms	297	$156	$151	$23	15%	—	$58 – $266
3	Aetna fee schedule · outpatient · +15 other terms	276	$156	$180	$105	58%	—	$52 – $929
4	WellCare fee schedule · outpatient · +6 other terms	184	$160	$165	$27	16%	—	$152 – $302
5	Blue Cross Blue Shield fee schedule · outpatient · +10 other terms	182	$158	$189	$87	46%	—	$0 – $548
6	Devoted fee schedule · outpatient · +3 other terms	163	$155	$156	$3	2%	—	$149 – $164
7	Cigna Healthspring fee schedule · outpatient · +2 other terms	116	$160	$158	$4	3%	—	$155 – $167
8	Molina fee schedule · outpatient · +12 other terms	98	$220	$210	$83	40%	—	$74 – $406
9	Cigna fee schedule · outpatient · +14 other terms	78	$158	$176	$54	30%	—	$149 – $454
10	Anthem fee schedule · outpatient · +10 other terms	73	$152	$156	$12	8%	—	$149 – $252
11	Superior Healthplan fee schedule · outpatient	40	$163	$163	$1	0%	—	$152 – $163
12	Kaiser fee schedule · outpatient · +4 other terms	39	$152	$154	$4	2%	—	$149 – $158
13	Clover fee schedule · outpatient · +1 other terms	37	$155	$157	$5	3%	—	$152 – $163
14	Bcbs Tx fee schedule · outpatient	31	$143	$146	$43	29%	—	$107 – $531
15	Optum fee schedule · outpatient · +6 other terms	25	$155	$180	$75	42%	—	$149 – $388
16	Oscar fee schedule · outpatient · +6 other terms	24	$152	$156	$5	3%	—	$152 – $163
17	Caresource facility · case rate · outpatient · +6 other terms	20	$37	$96	$101	105%	—	$23 – $310
18	Medicare fee schedule · outpatient · +4 other terms	18	$149	$149	$1	1%	—	$149 – $152
19	Ambetter facility · fee schedule · outpatient · +7 other terms	17	$225	$250	$27	11%	—	$225 – $279
20	Amerihealth Caritas fee schedule · outpatient · +3 other terms	17	$186	$172	$35	20%	—	$75 – $186
21	Wellmark fee schedule · both · +2 other terms	13	$137	$137	$2	1%	—	$137 – $148
22	Aetna Better Health fee schedule · outpatient · +2 other terms	12	$73	$106	$39	37%	—	$73 – $152
23	Bcbs Mn fee schedule · outpatient · +4 other terms	12	$136	$138	$36	26%	—	$69 – $165
24	Bcbs Nj fee schedule · outpatient	12	$152	$328	$223	68%	—	$152 – $672
25	Highmark fee schedule · outpatient · +5 other terms	12	$159	$167	$63	38%	—	$71 – $440

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