Flexible lumbar-sacral back brace

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

Support Lumbosacral

Payers reporting HCPCS L0628

Payer pricing summary

Low

Average

$176

Median

$93

High

$1.4k

Payer rate distribution

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Filter by billing class

#
1	UnitedHealthcare fee schedule · outpatient · +20 other terms	427	$65	$123	$166	135%	—	$1 – $1.4k
2	Aetna fee schedule · outpatient · +22 other terms	393	$63	$72	$47	65%	—	$1 – $520
3	Humana fee schedule · outpatient · +22 other terms	357	$65	$112	$164	147%	—	$1 – $797
4	Blue Cross Blue Shield fee schedule · outpatient · +20 other terms	264	$66	$122	$174	142%	—	$0 – $3.0k
5	WellCare fee schedule · outpatient · +11 other terms	234	$64	$65	$13	20%	—	$27 – $111
6	Devoted fee schedule · outpatient · +4 other terms	179	$65	$63	$10	16%	—	$41 – $95
7	Molina fee schedule · outpatient · +16 other terms	158	$75	$78	$34	43%	—	$1 – $221
8	Cigna fee schedule · outpatient · +18 other terms	133	$67	$193	$231	119%	—	$29 – $1.4k
9	Cigna Healthspring fee schedule · outpatient · +2 other terms	123	$67	$64	$8	13%	—	$43 – $91
10	Anthem fee schedule · outpatient · +16 other terms	100	$63	$185	$194	105%	—	$27 – $822
11	Kaiser fee schedule · outpatient · +17 other terms	84	$48	$123	$149	122%	—	$29 – $889
12	Caresource fee schedule · outpatient · +12 other terms	50	$65	$51	$24	46%	—	$1 – $86
13	Clover fee schedule · outpatient · +3 other terms	44	$65	$64	$9	14%	—	$56 – $89
14	Ambetter facility · fee schedule · outpatient · +9 other terms	43	$100	$135	$48	36%	—	$61 – $210
15	MultiPlan fee schedule · outpatient · +13 other terms	41	$527	$493	$244	50%	—	$60 – $1.0k
16	Superior Healthplan fee schedule · outpatient · +2 other terms	41	$65	$65	$4	6%	—	$60 – $89
17	Optum fee schedule · outpatient · +9 other terms	37	$65	$78	$34	44%	—	$41 – $154
18	Oscar fee schedule · outpatient · +8 other terms	36	$61	$66	$13	20%	—	$49 – $109
19	Medica fee schedule · outpatient · +10 other terms	30	$217	$218	$169	77%	—	$36 – $595
20	Medicare fee schedule · outpatient · +4 other terms	27	$41	$56	$19	34%	—	$41 – $94
21	Bcbs Tx fee schedule · outpatient · +2 other terms	23	$60	$66	$12	18%	—	$60 – $88
22	Regence facility · fee schedule · outpatient · +7 other terms	20	$44	$55	$23	41%	—	$24 – $94
23	Amerihealth Caritas fee schedule · outpatient · +3 other terms	19	$78	$78	$9	12%	—	$58 – $101
24	Tricare fee schedule · outpatient · +5 other terms	16	$65	$70	$10	14%	—	$65 – $90
25	Medical Mutual facility · fee schedule · outpatient · +4 other terms	15	$55	$66	$17	25%	—	$30 – $87

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