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-a-P-L Control Custom Fit
Low
$564
Average
$2.1k
Median
$2.0k
High
$4.0k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
54 payers; the 90th percentile is 2.2× 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 | 367 | $1.8k | $1.9k | $801 | 42% | — | $1 – $8.0k |
| 2 | Aetna fee schedule · outpatient · +16 other terms | 360 | $1.9k | $2.1k | $1.1k | 50% | — | $1 – $13.7k |
| 3 | Humana fee schedule · outpatient · +16 other terms | 318 | $1.9k | $2.7k | $2.7k | 100% | — | $1 – $12.7k |
| 4 | Blue Cross Blue Shield fee schedule · outpatient · +16 other terms | 229 | $2.0k | $2.5k | $1.5k | 61% | — | $0 – $8.7k |
| 5 | WellCare fee schedule · outpatient · +6 other terms | 208 | $1.8k | $1.8k | $318 | 17% | — | $1.6k – $3.4k |
| 6 | Devoted fee schedule · outpatient · +3 other terms | 165 | $1.9k | $1.8k | $142 | 8% | — | $1.7k – $2.2k |
| 7 | Molina fee schedule · outpatient · +11 other terms | 143 | $2.4k | $2.3k | $876 | 38% | — | $1 – $4.3k |
| 8 | Cigna Healthspring fee schedule · outpatient · +2 other terms | 116 | $1.9k | $1.8k | $177 | 10% | — | $1.7k – $2.2k |
| 9 | Cigna fee schedule · outpatient · +12 other terms | 110 | $2.0k | $2.3k | $916 | 40% | — | $1.6k – $5.9k |
| 10 | Anthem fee schedule · outpatient · +12 other terms | 85 | $1.9k | $3.0k | $2.6k | 85% | — | $1.1k – $12.5k |
| 11 | Kaiser fee schedule · outpatient · +10 other terms | 69 | $2.0k | $3.1k | $1.9k | 62% | — | $1.7k – $12.1k |
| 12 | Superior Healthplan fee schedule · outpatient · +1 other terms | 40 | $1.7k | $1.7k | $8 | 0% | — | $1.6k – $1.7k |
| 13 | Clover fee schedule · outpatient · +2 other terms | 37 | $1.7k | $1.8k | $151 | 8% | — | $1.7k – $2.2k |
| 14 | Oscar fee schedule · outpatient · +6 other terms | 36 | $2.0k | $2.1k | $679 | 32% | — | $1.6k – $3.7k |
| 15 | Ambetter facility · fee schedule · outpatient · +8 other terms | 34 | $3.1k | $3.6k | $869 | 24% | — | $1.8k – $4.8k |
| 16 | Optum fee schedule · outpatient · +3 other terms | 33 | $1.9k | $2.3k | $792 | 34% | — | $1.6k – $4.1k |
| 17 | Caresource fee schedule · outpatient · +7 other terms | 29 | $1.9k | $1.9k | $542 | 29% | — | $1 – $2.6k |
| 18 | Medica facility · fee schedule · outpatient · +7 other terms | 22 | $1.7k | $1.6k | $464 | 29% | — | $555 – $3.4k |
| 19 | Regence facility · fee schedule · outpatient · +4 other terms | 19 | $2.0k | $1.9k | $227 | 12% | — | $1.4k – $2.0k |
| 20 | Amerihealth Caritas fee schedule · outpatient · +2 other terms | 18 | $2.3k | $2.2k | $207 | 9% | — | $1.7k – $2.3k |
| 21 | Bcbs Tx fee schedule · outpatient | 18 | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 22 | Medicare fee schedule · outpatient · +4 other terms | 18 | $1.8k | $1.8k | $14 | 1% | — | $1.8k – $1.9k |
| 23 | Medical Mutual facility · fee schedule · outpatient · +2 other terms | 15 | $1.7k | $1.9k | $477 | 25% | — | $907 – $2.6k |
| 24 | Bcbs Mn fee schedule · outpatient · +6 other terms | 13 | $1.5k | $1.5k | $354 | 23% | — | $737 – $1.8k |
| 25 | Wellmark fee schedule · both · +3 other terms | 13 | $1.9k | $1.9k | $117 | 6% | — | $1.2k – $1.9k |
← Hospitals reporting HCPCS L0636 · Snapshot 20261112T181611Z-3fa9fb76