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
Lso sagit rigid panel prefab
Low
$376
Average
$1.4k
Median
$1.3k
High
$3.3k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
54 payers; the 90th percentile is 2.1× 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 · +16 other terms | 368 | $1.2k | $1.2k | $512 | 42% | — | $299 – $5.7k |
| 2 | Aetna fee schedule · outpatient · +14 other terms | 359 | $1.2k | $1.4k | $795 | 55% | — | $654 – $10.8k |
| 3 | Humana fee schedule · outpatient · +13 other terms | 317 | $1.3k | $1.9k | $2.0k | 106% | — | $630 – $9.4k |
| 4 | Blue Cross Blue Shield fee schedule · outpatient · +13 other terms | 229 | $1.3k | $1.8k | $1.1k | 63% | — | $0 – $6.4k |
| 5 | WellCare fee schedule · outpatient · +6 other terms | 208 | $1.3k | $1.3k | $192 | 15% | — | $1.1k – $2.3k |
| 6 | Devoted fee schedule · outpatient · +4 other terms | 165 | $1.2k | $1.2k | $74 | 6% | — | $1.1k – $1.5k |
| 7 | Molina fee schedule · outpatient · +6 other terms | 138 | $1.8k | $1.7k | $633 | 37% | — | $853 – $3.2k |
| 8 | Cigna Healthspring fee schedule · outpatient · +1 other terms | 116 | $1.2k | $1.3k | $91 | 7% | — | $1.1k – $1.5k |
| 9 | Cigna fee schedule · outpatient · +12 other terms | 103 | $1.4k | $1.4k | $562 | 40% | — | $388 – $5.9k |
| 10 | Anthem fee schedule · outpatient · +8 other terms | 80 | $1.1k | $1.6k | $1.6k | 98% | — | $804 – $9.2k |
| 11 | Kaiser fee schedule · outpatient · +7 other terms | 64 | $1.1k | $2.0k | $1.5k | 75% | — | $1.1k – $9.3k |
| 12 | Caresource fee schedule · outpatient · +5 other terms | 40 | $1.3k | $996 | $351 | 35% | — | $544 – $1.9k |
| 13 | Superior Healthplan fee schedule · outpatient · +2 other terms | 40 | $1.3k | $1.3k | $6 | 0% | — | $1.2k – $1.3k |
| 14 | Clover fee schedule · outpatient · +2 other terms | 37 | $1.3k | $1.3k | $102 | 8% | — | $1.1k – $1.5k |
| 15 | Oscar fee schedule · outpatient · +4 other terms | 36 | $1.4k | $1.5k | $418 | 28% | — | $1.2k – $2.5k |
| 16 | Ambetter facility · fee schedule · outpatient · +8 other terms | 34 | $2.2k | $2.5k | $578 | 23% | — | $1.1k – $3.3k |
| 17 | Optum fee schedule · outpatient · +3 other terms | 33 | $1.3k | $1.6k | $667 | 42% | — | $1.1k – $3.1k |
| 18 | Medica facility · fee schedule · outpatient · +5 other terms | 22 | $1.3k | $1.1k | $301 | 26% | — | $409 – $2.0k |
| 19 | Baylor Scott White Health Plan facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms | 20 | $1.6k | $1.5k | $220 | 15% | — | $1.1k – $1.8k |
| 20 | Regence facility · fee schedule · outpatient · +3 other terms | 19 | $1.1k | $1.2k | $36 | 3% | — | $1.1k – $1.2k |
| 21 | Amerihealth Caritas fee schedule · outpatient · +2 other terms | 18 | $1.6k | $1.5k | $141 | 9% | — | $1.1k – $1.6k |
| 22 | Bcbs Tx fee schedule · outpatient | 18 | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 23 | Medicare fee schedule · outpatient · +1 other terms | 18 | $1.1k | $1.1k | $8 | 1% | — | $1.1k – $1.1k |
| 24 | Medical Mutual facility · fee schedule · outpatient · +1 other terms | 15 | $1.2k | $1.4k | $350 | 25% | — | $669 – $1.9k |
| 25 | Bcbs Mn fee schedule · outpatient · +6 other terms | 13 | $1.1k | $1.1k | $261 | 23% | — | $543 – $1.3k |
← Hospitals reporting HCPCS L0635 · Snapshot 20261112T181611Z-3fa9fb76