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 2-Pc Shells Custom L0640
Low
$326
Average
$2.0k
Median
$1.5k
High
$16.5k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
56 payers; the 90th percentile is 2.5× 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 · +22 other terms | 381 | $1.3k | $1.3k | $379 | 29% | — | $1 – $4.2k |
| 2 | Aetna fee schedule · outpatient · +22 other terms | 367 | $1.3k | $1.5k | $743 | 49% | — | $644 – $8.4k |
| 3 | Humana fee schedule · outpatient · +20 other terms | 325 | $1.3k | $1.9k | $2.1k | 107% | — | $660 – $9.9k |
| 4 | Blue Cross Blue Shield fee schedule · outpatient · +20 other terms | 237 | $1.3k | $1.8k | $1.2k | 69% | — | $0 – $14.0k |
| 5 | WellCare fee schedule · outpatient · +10 other terms | 214 | $1.3k | $1.4k | $203 | 15% | — | $1.0k – $2.4k |
| 6 | Devoted fee schedule · outpatient · +6 other terms | 165 | $1.3k | $1.3k | $30 | 2% | — | $1.2k – $1.6k |
| 7 | Molina fee schedule · outpatient · +10 other terms | 140 | $1.8k | $1.8k | $667 | 38% | — | $830 – $3.4k |
| 8 | Cigna Healthspring fee schedule · outpatient · +4 other terms | 116 | $1.3k | $1.3k | $46 | 3% | — | $1.3k – $1.6k |
| 9 | Cigna fee schedule · outpatient · +19 other terms | 109 | $1.3k | $1.6k | $593 | 38% | — | $807 – $3.8k |
| 10 | Anthem fee schedule · outpatient · +18 other terms | 80 | $1.3k | $1.8k | $1.7k | 97% | — | $842 – $9.6k |
| 11 | Kaiser fee schedule · outpatient · +13 other terms | 69 | $1.3k | $2.0k | $1.4k | 70% | — | $1.2k – $9.2k |
| 12 | Caresource fee schedule · outpatient · +9 other terms | 47 | $1.3k | $1.3k | $292 | 22% | — | $707 – $2.2k |
| 13 | Clover fee schedule · outpatient · +3 other terms | 42 | $1.3k | $1.3k | $66 | 5% | — | $1.2k – $1.5k |
| 14 | Superior Healthplan fee schedule · outpatient · +2 other terms | 40 | $1.4k | $1.4k | $7 | 0% | — | $1.3k – $1.4k |
| 15 | Ambetter facility · fee schedule · outpatient · +8 other terms | 36 | $2.3k | $2.4k | $617 | 26% | — | $933 – $3.2k |
| 16 | Oscar fee schedule · outpatient · +8 other terms | 36 | $1.4k | $1.5k | $316 | 21% | — | $1.3k – $2.2k |
| 17 | Optum fee schedule · outpatient · +6 other terms | 34 | $1.3k | $1.7k | $676 | 40% | — | $1.2k – $3.2k |
| 18 | Medica facility · fee schedule · outpatient · +10 other terms | 26 | $1.3k | $1.2k | $298 | 25% | — | $429 – $2.1k |
| 19 | Medicare fee schedule · outpatient · +5 other terms | 23 | $1.2k | $1.3k | $11 | 1% | — | $1.2k – $1.3k |
| 20 | Regence facility · fee schedule · outpatient · +4 other terms | 19 | $1.4k | $1.3k | $103 | 8% | — | $1.0k – $1.4k |
| 21 | Amerihealth Caritas fee schedule · outpatient · +4 other terms | 18 | $1.6k | $1.5k | $86 | 6% | — | $1.3k – $1.6k |
| 22 | Bcbs Tx fee schedule · outpatient | 18 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 23 | Medical Mutual facility · fee schedule · outpatient · +2 other terms | 15 | $1.3k | $1.5k | $366 | 25% | — | $700 – $2.0k |
| 24 | Bcbs Mn fee schedule · outpatient · +8 other terms | 13 | $1.2k | $1.2k | $267 | 23% | — | $569 – $1.4k |
| 25 | Wellmark fee schedule · both · +5 other terms | 13 | $1.2k | $1.2k | $47 | 4% | — | $936 – $1.2k |
← Hospitals reporting HCPCS L0640 · Snapshot 20261111T120946Z-9134e7f7