Lumbar derotation pad for spinal 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

Addition,to Tlso Lumbar Pad P/ 2+ Parameters < L1240

Payers reporting HCPCS L1240

Payer pricing summary

Low

$31

Average

$129

Median

$112

High

$379

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	UnitedHealthcare fee schedule · outpatient · +16 other terms	372	$100	$104	$31	29%	—	$1 – $316
2	Aetna fee schedule · outpatient · +16 other terms	361	$106	$118	$59	50%	—	$56 – $746
3	Humana fee schedule · outpatient · +16 other terms	319	$110	$151	$155	102%	—	$57 – $741
4	Blue Cross Blue Shield fee schedule · outpatient · +14 other terms	231	$115	$138	$76	55%	—	$0 – $561
5	WellCare fee schedule · outpatient · +6 other terms	208	$99	$105	$15	15%	—	$88 – $176
6	Devoted fee schedule · outpatient · +4 other terms	165	$96	$100	$9	9%	—	$86 – $121
7	Molina fee schedule · outpatient · +7 other terms	140	$140	$135	$51	37%	—	$45 – $252
8	Cigna Healthspring fee schedule · outpatient · +2 other terms	116	$104	$102	$10	10%	—	$89 – $122
9	Cigna fee schedule · outpatient · +13 other terms	105	$114	$116	$39	33%	—	$58 – $328
10	Anthem fee schedule · outpatient · +12 other terms	80	$96	$140	$151	108%	—	$62 – $838
11	Kaiser fee schedule · outpatient · +6 other terms	64	$91	$158	$115	73%	—	$86 – $700
12	Ambetter facility · fee schedule · outpatient · +7 other terms	47	$169	$195	$55	28%	—	$81 – $281
13	Caresource fee schedule · outpatient · +5 other terms	41	$112	$113	$26	23%	—	$61 – $173
14	Superior Healthplan fee schedule · outpatient	40	$101	$101	$0	0%	—	$94 – $101
15	Clover fee schedule · outpatient · +3 other terms	37	$101	$101	$13	13%	—	$88 – $119
16	Oscar fee schedule · outpatient · +6 other terms	36	$118	$122	$34	28%	—	$94 – $202
17	Optum fee schedule · outpatient · +4 other terms	33	$112	$128	$51	40%	—	$86 – $241
18	Medica facility · fee schedule · outpatient · +7 other terms	22	$114	$102	$26	25%	—	$37 – $156
19	Regence facility · fee schedule · outpatient · +4 other terms	19	$93	$91	$4	4%	—	$79 – $95
20	Amerihealth Caritas fee schedule · outpatient · +1 other terms	18	$135	$130	$10	8%	—	$102 – $135
21	Bcbs Tx fee schedule · outpatient	18	$94	$94	—	—	—	$94 – $94
22	Medicare fee schedule · outpatient · +3 other terms	18	$86	$86	$1	1%	—	$86 – $87
23	Medical Mutual facility · fee schedule · outpatient · +2 other terms	15	$112	$128	$32	25%	—	$61 – $177
24	Tricare facility · fee schedule · outpatient · +2 other terms	15	$98	$95	$7	7%	—	$81 – $110
25	Highmark facility · fee schedule · outpatient · +4 other terms	14	$160	$163	$68	42%	—	$90 – $282

Page 1 of 3 · 53 payers