Pediatric plaster gauntlet cast supplies

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 Supply Guantlet Ped 0-10

Payers reporting HCPCS Q4015

Payer pricing summary

Low

Average

$12

Median

$10

High

$24

Payer rate distribution

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#
1	Humana fee schedule · outpatient · +14 other terms	299	$10	$15	$16	105%	—	$5 – $77
2	UnitedHealthcare fee schedule · outpatient · +15 other terms	295	$10	$10	$1	14%	—	$4 – $12
3	Aetna fee schedule · outpatient · +14 other terms	274	$10	$12	$7	56%	—	$5 – $60
4	WellCare fee schedule · outpatient · +6 other terms	184	$10	$11	$2	16%	—	$10 – $20
5	Blue Cross Blue Shield fee schedule · outpatient · +9 other terms	180	$10	$12	$6	45%	—	$0 – $36
6	Devoted fee schedule · outpatient · +2 other terms	163	$10	$10	$0	2%	—	$10 – $11
7	Cigna Healthspring fee schedule · outpatient · +2 other terms	116	$10	$10	$0	3%	—	$10 – $11
8	Molina fee schedule · outpatient · +9 other terms	96	$14	$14	$5	40%	—	$5 – $26
9	Cigna fee schedule · outpatient · +14 other terms	78	$10	$11	$3	30%	—	$10 – $29
10	Anthem fee schedule · outpatient · +10 other terms	73	$10	$10	$1	8%	—	$10 – $16
11	Superior Healthplan fee schedule · outpatient	40	$11	$11	$0	0%	—	$10 – $11
12	Kaiser fee schedule · outpatient · +5 other terms	39	$10	$10	$0	2%	—	$10 – $10
13	Clover fee schedule · outpatient · +1 other terms	37	$10	$10	$0	3%	—	$10 – $11
14	Bcbs Tx fee schedule · outpatient	31	$9	$9	$3	29%	—	$7 – $34
15	Optum fee schedule · outpatient · +6 other terms	25	$10	$12	$5	42%	—	$10 – $25
16	Oscar fee schedule · outpatient · +6 other terms	24	$10	$10	$0	3%	—	$10 – $11
17	Caresource facility · case rate · outpatient · +5 other terms	20	$16	$17	$4	24%	—	$10 – $27
18	Medicare fee schedule · outpatient · +2 other terms	18	$10	$10	$0	1%	—	$10 – $10
19	Ambetter facility · fee schedule · outpatient · +6 other terms	17	$15	$16	$2	11%	—	$15 – $18
20	Amerihealth Caritas fee schedule · outpatient · +1 other terms	17	$12	$11	$2	20%	—	$5 – $12
21	Wellmark fee schedule · both · +2 other terms	13	$9	$9	$0	1%	—	$9 – $10
22	Aetna Better Health fee schedule · outpatient · +2 other terms	12	$5	$7	$3	37%	—	$5 – $10
23	Bcbs Mn fee schedule · outpatient · +4 other terms	12	$9	$9	$2	26%	—	$4 – $11
24	Bcbs Nj fee schedule · outpatient	12	$10	$21	$14	68%	—	$10 – $44
25	Highmark fee schedule · outpatient · +5 other terms	12	$10	$11	$4	38%	—	$5 – $29

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