Lumbar bolster pad for scoliosis brace

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

Lumbar bolster pad

Payers reporting HCPCS L1030

Payer pricing summary

Low

$20

Average

$119

Median

$98

High

$424

Payer rate distribution

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#
1	Aetna fee schedule · outpatient · +12 other terms	359	$97	$99	$41	42%	—	$49 – $502
2	UnitedHealthcare fee schedule · outpatient · +11 other terms	358	$97	$87	$24	27%	—	$1 – $249
3	Humana fee schedule · outpatient · +11 other terms	317	$96	$139	$158	113%	—	$49 – $750
4	Blue Cross Blue Shield fee schedule · outpatient · +11 other terms	218	$99	$116	$59	51%	—	$0 – $470
5	WellCare fee schedule · outpatient · +5 other terms	208	$100	$99	$12	12%	—	$72 – $143
6	Devoted fee schedule · outpatient · +3 other terms	165	$97	$95	$9	9%	—	$70 – $104
7	Molina fee schedule · outpatient · +4 other terms	138	$119	$129	$51	40%	—	$58 – $255
8	Cigna Healthspring fee schedule · outpatient · +2 other terms	116	$99	$96	$8	9%	—	$73 – $105
9	Cigna fee schedule · outpatient · +9 other terms	102	$100	$97	$29	29%	—	$70 – $282
10	Anthem fee schedule · outpatient · +6 other terms	81	$73	$116	$131	112%	—	$54 – $722
11	Kaiser fee schedule · outpatient · +5 other terms	64	$75	$122	$88	72%	—	$70 – $551
12	Ambetter facility · fee schedule · outpatient · +6 other terms	45	$144	$162	$54	33%	—	$72 – $244
13	Superior Healthplan fee schedule · outpatient	40	$102	$102	$0	0%	—	$96 – $102
14	Clover fee schedule · outpatient · +2 other terms	37	$97	$88	$15	17%	—	$72 – $102
15	Oscar fee schedule · outpatient · +4 other terms	36	$102	$107	$16	15%	—	$88 – $164
16	Optum fee schedule · outpatient · +2 other terms	33	$97	$117	$59	50%	—	$70 – $244
17	Caresource fee schedule · outpatient · +5 other terms	28	$97	$103	$28	27%	—	$54 – $149
18	Medica facility · fee schedule · outpatient · +5 other terms	22	$98	$88	$22	25%	—	$32 – $134
19	Regence facility · fee schedule · outpatient · +3 other terms	19	$76	$74	$4	6%	—	$63 – $77
20	Amerihealth Caritas fee schedule · outpatient · +1 other terms	18	$117	$111	$13	12%	—	$75 – $117
21	Bcbs Tx fee schedule · outpatient	18	$96	$96	—	—	—	$96 – $96
22	Medicare fee schedule · outpatient · +3 other terms	18	$70	$71	$1	1%	—	$70 – $72
23	Tricare facility · fee schedule · outpatient · +2 other terms	16	$73	$74	$6	8%	—	$66 – $96
24	Medical Mutual facility · fee schedule · outpatient · +1 other terms	15	$96	$110	$28	25%	—	$52 – $152
25	Highmark facility · fee schedule · outpatient · +4 other terms	14	$126	$125	$51	40%	—	$70 – $207

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