Low-profile hip pad add-on for back 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 Trochanteric Pad L1290

Payers reporting HCPCS L1290

Payer pricing summary

Low

$31

Average

$133

Median

$113

High

$466

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	Aetna fee schedule · outpatient · +16 other terms	364	$95	$116	$73	63%	—	$57 – $1.2k
2	UnitedHealthcare fee schedule · outpatient · +18 other terms	363	$94	$100	$27	27%	—	$1 – $306
3	Humana fee schedule · outpatient · +16 other terms	322	$98	$147	$144	98%	—	$49 – $695
4	Blue Cross Blue Shield fee schedule · outpatient · +14 other terms	230	$117	$134	$69	51%	—	$0 – $440
5	WellCare fee schedule · outpatient · +8 other terms	208	$94	$102	$18	17%	—	$89 – $176
6	Devoted fee schedule · outpatient · +4 other terms	165	$90	$97	$11	12%	—	$87 – $123
7	Molina fee schedule · outpatient · +8 other terms	140	$133	$128	$48	37%	—	$40 – $237
8	Cigna Healthspring fee schedule · outpatient · +2 other terms	116	$98	$99	$13	14%	—	$90 – $124
9	Cigna fee schedule · outpatient · +16 other terms	104	$111	$113	$31	27%	—	$58 – $280
10	Anthem fee schedule · outpatient · +12 other terms	80	$92	$131	$126	96%	—	$57 – $716
11	Kaiser fee schedule · outpatient · +8 other terms	64	$92	$156	$111	71%	—	$87 – $677
12	Ambetter facility · fee schedule · outpatient · +8 other terms	47	$171	$191	$59	31%	—	$69 – $287
13	Superior Healthplan fee schedule · outpatient	40	$95	$95	$0	0%	—	$89 – $95
14	Clover fee schedule · outpatient · +3 other terms	37	$95	$101	$14	14%	—	$89 – $121
15	Optum fee schedule · outpatient · +4 other terms	36	$95	$121	$45	37%	—	$87 – $226
16	Oscar fee schedule · outpatient · +7 other terms	36	$119	$119	$37	31%	—	$89 – $205
17	Caresource fee schedule · outpatient · +5 other terms	29	$115	$110	$28	25%	—	$57 – $148
18	Medica facility · fee schedule · outpatient · +7 other terms	22	$98	$89	$23	26%	—	$32 – $150
19	Regence facility · fee schedule · outpatient · +4 other terms	19	$94	$91	$5	6%	—	$77 – $96
20	Amerihealth Caritas fee schedule · outpatient · +2 other terms	18	$138	$132	$13	10%	—	$96 – $138
21	Bcbs Tx fee schedule · outpatient	18	$89	$89	—	—	—	$89 – $89
22	Medicare fee schedule · outpatient · +3 other terms	18	$87	$87	$1	1%	—	$87 – $89
23	Tricare facility · fee schedule · outpatient · +2 other terms	16	$93	$93	$6	7%	—	$81 – $113
24	Medical Mutual facility · fee schedule · outpatient · +2 other terms	15	$95	$110	$27	25%	—	$52 – $151
25	Highmark facility · fee schedule · outpatient · +4 other terms	14	$157	$158	$66	41%	—	$90 – $266

Page 1 of 3 · 53 payers