Back brace with rigid front and back panels for lower spine

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

BRACE BACK EPIC LO 627

Payers reporting HCPCS L0642

Payer pricing summary

Low

$42

Average

$358

Median

$364

High

$747

Payer rate distribution

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#
1	Aetna fee schedule · outpatient · +15 other terms	392	$307	$347	$217	63%	—	$137 – $2.5k
2	UnitedHealthcare fee schedule · outpatient · +16 other terms	381	$311	$331	$124	37%	—	$120 – $1.4k
3	Humana fee schedule · outpatient · +16 other terms	349	$316	$536	$792	148%	—	$141 – $3.9k
4	Blue Cross Blue Shield fee schedule · outpatient · +14 other terms	234	$314	$371	$254	69%	—	$0 – $2.4k
5	WellCare fee schedule · outpatient · +9 other terms	229	$319	$321	$63	20%	—	$145 – $546
6	Devoted fee schedule · outpatient · +6 other terms	179	$317	$307	$51	16%	—	$200 – $468
7	Molina fee schedule · outpatient · +11 other terms	151	$365	$386	$166	43%	—	$137 – $1.1k
8	Cigna Healthspring fee schedule · outpatient · +3 other terms	123	$326	$312	$40	13%	—	$210 – $447
9	Cigna fee schedule · outpatient · +15 other terms	117	$319	$404	$241	60%	—	$141 – $1.3k
10	Anthem fee schedule · outpatient · +14 other terms	89	$311	$449	$398	89%	—	$141 – $2.0k
11	Kaiser fee schedule · outpatient · +12 other terms	74	$214	$307	$235	77%	—	$141 – $1.7k
12	Clover fee schedule · outpatient · +3 other terms	44	$316	$315	$43	14%	—	$273 – $434
13	Superior Healthplan fee schedule · outpatient · +2 other terms	41	$316	$320	$20	6%	—	$293 – $434
14	Ambetter facility · fee schedule · outpatient · +9 other terms	36	$488	$664	$250	38%	—	$298 – $1.0k
15	Optum fee schedule · outpatient · +5 other terms	36	$319	$385	$169	44%	—	$200 – $753
16	Oscar fee schedule · outpatient · +7 other terms	36	$297	$325	$64	20%	—	$239 – $536
17	Caresource fee schedule · outpatient · +8 other terms	33	$319	$343	$41	12%	—	$274 – $419
18	Bcbs Tx fee schedule · outpatient	23	$293	$324	$58	18%	—	$293 – $433
19	Medicare fee schedule · outpatient · +1 other terms	23	$200	$244	$71	29%	—	$200 – $406
20	Regence facility · fee schedule · outpatient · +7 other terms	20	$218	$264	$108	41%	—	$116 – $461
21	Amerihealth Caritas fee schedule · outpatient · +3 other terms	19	$383	$382	$46	12%	—	$286 – $496
22	Medical Mutual facility · fee schedule · outpatient · +2 other terms	15	$271	$322	$81	25%	—	$148 – $428
23	Tricare fee schedule · outpatient · +4 other terms	15	$319	$344	$49	14%	—	$319 – $443
24	Medica fee schedule · outpatient · +12 other terms	14	$508	$558	$171	31%	—	$318 – $775
25	Bcbs Mn fee schedule · outpatient · +6 other terms	13	$401	$391	$99	25%	—	$224 – $538

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