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.
Original text from hospital filings
TLSO rigid plastic custom fa
Low
$1
Average
$2.2k
Median
$2.0k
High
$6.9k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
54 payers; the 90th percentile is 2.3× the 10th. Each bar is a price range and its height is how many payers fall in it. Hover a bar, or a row in the ladder, for details.
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| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | UnitedHealthcare fee schedule · outpatient · +18 other terms | 373 | $1.8k | $1.8k | $504 | 28% | — | $366 – $6.3k |
| 2 | Aetna fee schedule · outpatient · +17 other terms | 361 | $1.8k | $2.1k | $1.1k | 50% | — | $815 – $12.8k |
| 3 | Humana fee schedule · outpatient · +17 other terms | 319 | $1.8k | $2.6k | $2.8k | 107% | — | $953 – $13.6k |
| 4 | Blue Cross Blue Shield fee schedule · outpatient · +14 other terms | 230 | $1.8k | $2.4k | $1.3k | 55% | — | $0 – $8.5k |
| 5 | WellCare fee schedule · outpatient · +5 other terms | 209 | $1.8k | $1.9k | $386 | 21% | — | $366 – $3.9k |
| 6 | Devoted fee schedule · outpatient · +5 other terms | 165 | $1.8k | $1.8k | $117 | 7% | — | $1.6k – $2.2k |
| 7 | Molina fee schedule · outpatient · +9 other terms | 140 | $2.6k | $2.5k | $942 | 38% | — | $909 – $4.6k |
| 8 | Cigna Healthspring fee schedule · outpatient · +2 other terms | 116 | $1.8k | $1.8k | $92 | 5% | — | $1.6k – $2.2k |
| 9 | Cigna fee schedule · outpatient · +14 other terms | 108 | $2.0k | $2.1k | $644 | 31% | — | $749 – $5.4k |
| 10 | Anthem fee schedule · outpatient · +10 other terms | 81 | $2.0k | $2.6k | $2.4k | 96% | — | $1.1k – $13.9k |
| 11 | Kaiser fee schedule · outpatient · +6 other terms | 64 | $2.1k | $3.2k | $2.2k | 69% | — | $1.9k – $14.0k |
| 12 | Caresource fee schedule · outpatient · +6 other terms | 42 | $1.7k | $1.8k | $470 | 26% | — | $774 – $2.9k |
| 13 | Superior Healthplan fee schedule · outpatient · +1 other terms | 40 | $1.9k | $1.8k | $9 | 0% | — | $1.7k – $1.9k |
| 14 | Clover fee schedule · outpatient · +2 other terms | 37 | $1.9k | $1.8k | $120 | 6% | — | $1.6k – $2.2k |
| 15 | Oscar fee schedule · outpatient · +6 other terms | 36 | $1.7k | $2.1k | $549 | 27% | — | $1.7k – $3.6k |
| 16 | Ambetter facility · fee schedule · outpatient · +7 other terms | 34 | $3.3k | $3.3k | $617 | 19% | — | $1.6k – $4.1k |
| 17 | Optum fee schedule · outpatient · +4 other terms | 33 | $2.0k | $2.4k | $902 | 38% | — | $1.6k – $4.4k |
| 18 | Medica facility · fee schedule · outpatient · +8 other terms | 22 | $1.9k | $1.8k | $493 | 28% | — | $619 – $3.5k |
| 19 | Regence facility · fee schedule · outpatient · +4 other terms | 19 | $2.1k | $2.0k | $180 | 9% | — | $1.6k – $2.2k |
| 20 | Amerihealth Caritas fee schedule · outpatient · +1 other terms | 18 | $2.0k | $1.9k | $94 | 5% | — | $1.7k – $2.0k |
| 21 | Bcbs Tx fee schedule · outpatient | 18 | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
| 22 | Medicare fee schedule · outpatient · +4 other terms | 18 | $2.0k | $2.0k | $15 | 1% | — | $2.0k – $2.0k |
| 23 | Medical Mutual facility · fee schedule · outpatient · +2 other terms | 15 | $1.9k | $2.1k | $529 | 25% | — | $1.0k – $2.9k |
| 24 | Bcbs Mn fee schedule · outpatient · +6 other terms | 13 | $1.7k | $1.7k | $394 | 23% | — | $821 – $2.0k |
| 25 | Wellmark fee schedule · both · +5 other terms | 13 | $2.0k | $2.0k | $110 | 5% | — | $1.4k – $2.0k |
← Hospitals reporting HCPCS L0480 · Snapshot 20261112T181611Z-3fa9fb76