Spinal brace with rigid plastic shells

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

TLSO 2 piece rigid shell

Payers reporting HCPCS L0491

Payer pricing summary

Low

$239

Average

$1.1k

Median

$989

High

$2.6k

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	Aetna fee schedule · outpatient · +13 other terms	361	$953	$1.1k	$498	45%	—	$472 – $6.2k
2	UnitedHealthcare fee schedule · outpatient · +14 other terms	359	$954	$949	$223	23%	—	$292 – $3.1k
3	Humana fee schedule · outpatient · +12 other terms	320	$945	$1.4k	$1.5k	107%	—	$439 – $7.3k
4	Blue Cross Blue Shield fee schedule · outpatient · +10 other terms	218	$968	$1.2k	$647	53%	—	$0 – $4.6k
5	WellCare fee schedule · outpatient · +7 other terms	211	$977	$998	$160	16%	—	$292 – $1.8k
6	Devoted fee schedule · outpatient · +3 other terms	165	$949	$954	$22	2%	—	$917 – $1.1k
7	Molina fee schedule · outpatient · +5 other terms	138	$1.4k	$1.3k	$488	37%	—	$655 – $2.5k
8	Cigna Healthspring fee schedule · outpatient · +1 other terms	116	$968	$967	$34	3%	—	$949 – $1.2k
9	Cigna fee schedule · outpatient · +11 other terms	103	$977	$1.1k	$301	28%	—	$476 – $2.8k
10	Anthem fee schedule · outpatient · +7 other terms	81	$936	$1.3k	$1.2k	96%	—	$618 – $7.1k
11	Kaiser fee schedule · outpatient · +4 other terms	64	$973	$1.5k	$1.1k	70%	—	$917 – $6.8k
12	Superior Healthplan fee schedule · outpatient · +1 other terms	40	$996	$996	$5	0%	—	$930 – $996
13	Clover fee schedule · outpatient · +2 other terms	37	$949	$955	$51	5%	—	$903 – $1.1k
14	Optum fee schedule · outpatient · +3 other terms	35	$949	$1.2k	$493	40%	—	$911 – $2.4k
15	Oscar fee schedule · outpatient · +3 other terms	35	$996	$1.1k	$219	20%	—	$930 – $1.6k
16	Ambetter facility · fee schedule · outpatient · +6 other terms	34	$1.7k	$1.8k	$428	24%	—	$903 – $2.4k
17	Caresource fee schedule · outpatient · +4 other terms	31	$949	$988	$266	27%	—	$616 – $1.5k
18	Baylor Scott White Health Plan facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms	26	$615	$599	$50	8%	—	$542 – $665
19	Medica facility · fee schedule · outpatient · +5 other terms	22	$965	$886	$231	26%	—	$315 – $1.6k
20	Regence facility · fee schedule · outpatient · +3 other terms	19	$992	$952	$75	8%	—	$768 – $1.0k
21	Amerihealth Caritas fee schedule · outpatient · +3 other terms	18	$1.1k	$1.1k	$63	6%	—	$940 – $1.1k
22	Bcbs Tx fee schedule · outpatient	18	$930	$930	—	—	—	$930 – $930
23	Medicare fee schedule · outpatient · +1 other terms	18	$917	$920	$7	1%	—	$917 – $936
24	Medical Mutual facility · fee schedule · outpatient · +1 other terms	15	$944	$1.1k	$269	25%	—	$514 – $1.5k
25	Bcbs Mn fee schedule · outpatient · +6 other terms	13	$858	$858	$200	23%	—	$418 – $1.0k

Page 1 of 3 · 54 payers