Pediatric fiberglass 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 SUPPLIES; GAUNTLET CAST (INCLUDES LOWER FOREARM AND HAND); PEDIATRIC (0-10 YEARS); FIBERGLASS

Payers reporting HCPCS Q4016

Payer pricing summary

Low

Average

$20

Median

$17

High

$38

Payer rate distribution

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#
1	Humana fee schedule · outpatient · +17 other terms	301	$17	$26	$27	105%	—	$8 – $130
2	UnitedHealthcare fee schedule · outpatient · +20 other terms	289	$17	$16	$2	14%	—	$7 – $19
3	Aetna fee schedule · outpatient · +17 other terms	274	$17	$20	$11	56%	—	$10 – $101
4	WellCare fee schedule · outpatient · +8 other terms	185	$17	$18	$3	16%	—	$13 – $33
5	Blue Cross Blue Shield fee schedule · outpatient · +12 other terms	182	$17	$21	$9	46%	—	$0 – $60
6	Devoted fee schedule · outpatient · +4 other terms	163	$17	$17	$0	2%	—	$16 – $18
7	Cigna Healthspring fee schedule · outpatient · +2 other terms	116	$17	$17	$0	3%	—	$17 – $18
8	Molina fee schedule · outpatient · +14 other terms	97	$24	$23	$9	40%	—	$8 – $44
9	Cigna fee schedule · outpatient · +17 other terms	80	$17	$19	$6	31%	—	$16 – $49
10	Anthem fee schedule · outpatient · +12 other terms	74	$17	$17	$1	9%	—	$13 – $28
11	Superior Healthplan fee schedule · outpatient	40	$18	$18	$0	1%	—	$17 – $18
12	Kaiser fee schedule · outpatient · +8 other terms	39	$17	$17	$0	2%	—	$16 – $17
13	Clover fee schedule · outpatient · +2 other terms	37	$17	$17	$1	3%	—	$17 – $18
14	Bcbs Tx fee schedule · outpatient	31	$16	$16	$5	29%	—	$12 – $58
15	Optum fee schedule · outpatient · +8 other terms	25	$17	$20	$8	42%	—	$16 – $42
16	Oscar fee schedule · outpatient · +7 other terms	24	$17	$17	$1	3%	—	$17 – $18
17	Caresource facility · case rate · outpatient · +7 other terms	20	$11	$16	$8	54%	—	$7 – $34
18	Medicare fee schedule · outpatient · +4 other terms	18	$16	$16	$0	1%	—	$16 – $17
19	Amerihealth Caritas fee schedule · outpatient · +6 other terms	17	$20	$19	$4	20%	—	$8 – $20
20	Ambetter facility · fee schedule · outpatient · +9 other terms	16	$27	$27	$3	11%	—	$25 – $30
21	Wellmark fee schedule · both · +3 other terms	13	$15	$15	$0	1%	—	$15 – $16
22	Aetna Better Health fee schedule · outpatient · +5 other terms	12	$8	$12	$4	37%	—	$8 – $17
23	Bcbs Mn fee schedule · outpatient · +4 other terms	12	$15	$15	$4	26%	—	$7 – $18
24	Bcbs Nj fee schedule · outpatient	12	$17	$36	$24	68%	—	$17 – $73
25	Highmark fee schedule · outpatient · +10 other terms	12	$17	$18	$7	38%	—	$8 – $48

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