Short arm splint, fiberglass (adult)

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; SHORT ARM SPLINT; ADULT (11+ YEARS); FIBERGLASS

Payers reporting HCPCS Q4022

Payer pricing summary

Low

Average

$26

Median

$21

High

$103

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	Humana fee schedule · outpatient · +22 other terms	319	$16	$23	$25	105%	—	$7 – $119
2	UnitedHealthcare fee schedule · outpatient · +22 other terms	317	$16	$15	$3	22%	—	$1 – $21
3	Aetna fee schedule · outpatient · +20 other terms	287	$16	$20	$13	63%	—	$3 – $93
4	WellCare fee schedule · outpatient · +14 other terms	192	$16	$16	$3	16%	—	$13 – $30
5	Blue Cross Blue Shield fee schedule · outpatient · +19 other terms	190	$16	$20	$22	110%	—	$0 – $420
6	Devoted fee schedule · outpatient · +8 other terms	163	$16	$16	$0	2%	—	$15 – $16
7	Cigna Healthspring fee schedule · outpatient · +3 other terms	121	$16	$16	$0	3%	—	$15 – $17
8	Molina fee schedule · outpatient · +17 other terms	106	$20	$21	$9	42%	—	$7 – $65
9	Cigna fee schedule · outpatient · +20 other terms	87	$16	$17	$5	31%	—	$7 – $45
10	Anthem fee schedule · outpatient · +17 other terms	75	$15	$16	$1	9%	—	$14 – $25
11	Superior Healthplan fee schedule · outpatient	40	$16	$16	$0	0%	—	$15 – $16
12	Kaiser fee schedule · outpatient · +14 other terms	39	$15	$15	$0	2%	—	$15 – $16
13	Clover fee schedule · outpatient · +5 other terms	37	$16	$16	$0	3%	—	$15 – $16
14	Bcbs Tx fee schedule · outpatient	31	$14	$15	$4	29%	—	$11 – $53
15	Optum fee schedule · outpatient · +14 other terms	30	$15	$18	$7	40%	—	$15 – $39
16	Oscar fee schedule · outpatient · +12 other terms	24	$15	$16	$1	3%	—	$15 – $16
17	Caresource facility · case rate · outpatient · +9 other terms	20	$17	$19	$6	31%	—	$10 – $31
18	Amerihealth Caritas fee schedule · outpatient · +8 other terms	18	$19	$17	$3	20%	—	$7 – $21
19	Medicare fee schedule · outpatient · +8 other terms	18	$15	$15	$0	1%	—	$15 – $15
20	Ambetter facility · fee schedule · outpatient · +12 other terms	17	$22	$25	$3	11%	—	$22 – $28
21	Medcost professional · percent of total billed charges · outpatientfrom % of charges · +1 other terms	16	$39	$37	$4	11%	—	$23 – $39
22	Medica professional · fee schedule · outpatient · +17 other terms	16	$16	$17	$2	13%	—	$15 – $26
23	Tricare facility · fee schedule · outpatient · +11 other terms	14	$16	$23	$18	78%	—	$6 – $59
24	Highmark facility · fee schedule · outpatient · +11 other terms	13	$28	$33	$23	70%	—	$14 – $104
25	Wellmark fee schedule · both · +11 other terms	13	$14	$14	$0	1%	—	$14 – $15

Page 1 of 3 · 54 payers