LSO flex w/rigid stays cust

Payers reporting HCPCS L0629

Payer pricing summary

Low

Average

$566

Median

$358

High

$2.2k

Payer rate distribution

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Filter by billing class

#
1	Blue Cross Blue Shield facility · fee schedule · outpatient · +6 other terms	33	$268	$439	$362	82%	—	$0 – $1.5k
2	Aetna fee schedule · outpatient · +10 other terms	22	$173	$434	$248	57%	—	$121 – $1.1k
3	UnitedHealthcare fee schedule · outpatient · +7 other terms	18	$274	$473	$415	88%	—	$137 – $1.4k
4	Anthem facility · case rate · outpatient · +5 other terms	15	$53	$58	$14	23%	—	$36 – $90
5	Caresource facility · case rate · outpatient · +2 other terms	15	$54	$58	$13	23%	—	$36 – $92
6	Molina facility · case rate · outpatient · +2 other terms	15	$53	$58	$13	23%	—	$37 – $90
7	Wellmark fee schedule · both · +1 other terms	13	$1.0k	$1.0k	—	—	—	$1.0k – $1.0k
8	Bcbs Mn fee schedule · outpatient · +3 other terms	12	$443	$333	$190	57%	—	$140 – $555
9	Optum facility · case rate · outpatient · +1 other terms	11	$50	$55	$12	22%	—	$45 – $81
10	Superior Healthplan percent of total billed charges · outpatientfrom % of charges	11	$185	$198	$176	89%	—	$58 – $780
11	Cigna professional · fee schedule · outpatient · +5 other terms	10	$192	$189	$6	3%	—	$175 – $192
12	Healthcare Highways percent of total billed charges · outpatientfrom % of charges	10	$882	$889	$754	85%	—	$282 – $3.8k
13	Highmark fee schedule · outpatient · +1 other terms	10	$228	$228	—	—	—	$228 – $228
14	Humana fee schedule · outpatient · +5 other terms	8	$173	$304	$188	62%	—	$173 – $691
15	Aetna Better Health fee schedule · inpatient · +1 other terms	7	$178	$178	—	—	—	$178 – $178
16	Devoted facility · percent of total billed charges · outpatientfrom % of charges	3	$68	$68	$6	9%	—	$60 – $75
17	First Health professional · fee schedule · both · +2 other terms	3	$190	$190	—	—	—	$190 – $190
18	Medcost fee schedule · outpatient	3	$647	$644	$33	5%	—	$605 – $680
19	Regence facility · percent of total billed charges · bothfrom % of charges · +1 other terms	3	$162	$162	—	—	—	$162 – $162
20	WellCare fee schedule · outpatient	3	$137	$168	$44	26%	—	$137 – $230
21	Beechstreet fee schedule · outpatient	2	$651	$651	—	—	—	$651 – $651
22	Healthpartners facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms	2	$1.7k	$1.7k	$369	22%	—	$1.3k – $2.2k
23	Magellan percent of total billed charges · outpatientfrom % of charges	2	$1.5k	$1.5k	$1.0k	69%	—	$673 – $3.5k
24	Medica facility · percent of total billed charges · outpatientfrom % of charges	2	$6	$6	—	—	—	$6 – $6
25	MultiPlan fee schedule · outpatient · +4 other terms	2	$651	$651	—	—	—	$651 – $651

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← Hospitals reporting HCPCS L0629 · Snapshot 20261113T090226Z-3ce6c0b8