Scoliosis brace upright cover add-on

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

Covers for upright each

Payers reporting HCPCS L1120

Payer pricing summary

Low

$16

Average

$61

Median

$54

High

$128

Payer rate distribution

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Filter by billing class

#
1	Aetna fee schedule · outpatient · +11 other terms	359	$51	$61	$39	65%	—	$25 – $577
2	UnitedHealthcare fee schedule · outpatient · +11 other terms	356	$51	$52	$14	26%	—	$22 – $187
3	Humana fee schedule · outpatient · +10 other terms	317	$50	$78	$87	111%	—	$24 – $413
4	Blue Cross Blue Shield fee schedule · outpatient · +9 other terms	218	$53	$69	$36	52%	—	$0 – $256
5	WellCare fee schedule · outpatient · +4 other terms	208	$53	$55	$7	13%	—	$45 – $89
6	Devoted fee schedule · outpatient · +3 other terms	165	$50	$52	$2	5%	—	$46 – $62
7	Molina fee schedule · outpatient · +5 other terms	138	$73	$74	$28	38%	—	$28 – $141
8	Cigna Healthspring fee schedule · outpatient · +2 other terms	116	$54	$53	$2	3%	—	$49 – $63
9	Cigna fee schedule · outpatient · +8 other terms	102	$53	$58	$16	27%	—	$47 – $137
10	Anthem fee schedule · outpatient · +6 other terms	80	$49	$66	$61	93%	—	$26 – $351
11	Kaiser fee schedule · outpatient · +6 other terms	64	$50	$90	$68	76%	—	$47 – $415
12	Ambetter facility · fee schedule · outpatient · +6 other terms	44	$84	$91	$21	23%	—	$45 – $125
13	Superior Healthplan fee schedule · outpatient	40	$56	$56	$0	0%	—	$53 – $56
14	Clover fee schedule · outpatient · +2 other terms	37	$50	$50	$5	10%	—	$45 – $61
15	Oscar fee schedule · outpatient · +4 other terms	36	$53	$61	$17	27%	—	$51 – $103
16	Optum fee schedule · outpatient · +2 other terms	33	$50	$67	$30	45%	—	$45 – $134
17	Caresource fee schedule · outpatient · +5 other terms	28	$50	$52	$13	26%	—	$26 – $72
18	Medica facility · fee schedule · outpatient · +5 other terms	22	$48	$44	$11	26%	—	$16 – $76
19	Regence facility · fee schedule · outpatient · +4 other terms	19	$51	$52	$2	3%	—	$47 – $54
20	Amerihealth Caritas fee schedule · outpatient · +1 other terms	18	$60	$59	$3	5%	—	$51 – $60
21	Bcbs Tx fee schedule · outpatient	18	$53	$53	—	—	—	$53 – $53
22	Medicare fee schedule · outpatient · +1 other terms	18	$47	$48	$0	1%	—	$47 – $48
23	Tricare facility · fee schedule · outpatient · +2 other terms	16	$49	$48	$2	5%	—	$41 – $50
24	Medical Mutual facility · fee schedule · outpatient · +2 other terms	15	$47	$54	$13	25%	—	$25 – $74
25	Highmark facility · fee schedule · outpatient · +4 other terms	14	$86	$84	$35	42%	—	$46 – $141

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