Intrauterine air polymer foam

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

Description Not Available

Payers reporting HCPCS S4024

Payer pricing summary

Low

$23

Average

$584

Median

$321

High

$2.6k

Payer rate distribution

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Filter by billing class

#
1	Cigna fee schedule · outpatient · +7 other terms	109	$1.9k	$3.3k	$2.3k	70%	—	$863 – $8.1k
2	Blue Cross Blue Shield fee schedule · outpatient · +2 other terms	63	$2.5k	$2.8k	$1.4k	50%	—	$1 – $5.2k
3	Aetna facility · fee schedule · outpatient · +7 other terms	28	$2.3k	$2.2k	$552	25%	—	$893 – $2.9k
4	Anthem facility · case rate · outpatient · +3 other terms	15	$23	$25	$6	23%	—	$15 – $38
5	Caresource facility · case rate · outpatient · +1 other terms	15	$23	$25	$6	23%	—	$15 – $39
6	Molina facility · case rate · outpatient · +1 other terms	15	$23	$25	$6	23%	—	$16 – $38
7	UnitedHealthcare facility · case rate · outpatient · +7 other terms	15	$23	$25	$6	23%	—	$16 – $39
8	Wellmark fee schedule · both · +1 other terms	13	$93	$93	—	—	—	$93 – $93
9	Amerihealth Caritas percent of total billed charges · outpatientfrom % of charges	12	$119	$135	$41	30%	—	$89 – $191
10	Bcbs Nc percent of total billed charges · outpatientfrom % of charges · +1 other terms	12	$268	$263	$18	7%	—	$166 – $276
11	Beechstreet percent of total billed charges · inpatientfrom % of charges · +1 other terms	12	$788	$791	$23	3%	—	$761 – $840
12	Medcost percent of total billed charges · inpatientfrom % of charges · +1 other terms	12	$495	$524	$119	23%	—	$271 – $840
13	WellCare percent of total billed charges · outpatientfrom % of charges	12	$121	$138	$42	30%	—	$90 – $194
14	Ambetter percent of total billed charges · outpatientfrom % of charges · +1 other terms	11	$289	$300	$39	13%	—	$254 – $413
15	Highmark fee schedule · outpatient · +2 other terms	11	$1.0k	$1.0k	$13	1%	—	$949 – $1.1k
16	MultiPlan percent of total billed charges · inpatientfrom % of charges · +1 other terms	11	$823	$815	$17	2%	—	$788 – $831
17	Optum facility · case rate · outpatient	11	$21	$23	$5	22%	—	$19 – $35
18	Magellan percent of total billed charges · outpatientfrom % of charges	10	$525	$525	—	—	—	$525 – $525
19	Excellus facility · fee schedule · outpatient	5	$154	$173	$104	60%	—	$99 – $444
20	First Health professional · fee schedule · both · +2 other terms	3	$1.0k	$1.0k	—	—	—	$1.0k – $1.0k
21	Sanford Health Plan fee schedule · outpatient · +1 other terms	3	$95	$95	—	—	—	$95 – $95
22	Humana facility · other · outpatient · +2 other terms	2	$33	$33	$5	15%	—	$29 – $38
23	Bcbs Id professional · fee schedule · outpatient	1	$95	$95	—	—	—	$95 – $95
24	Cigna Healthspring percent of total billed charges · outpatientfrom % of charges	1	$166	$166	—	—	—	$166 – $166