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.
Original text from hospital filings
HCHG CSTM L0464 TLSO 4MOD SACRO-SCAP PRE
Cambridge, MN
See all hospitals reporting HCPCS L0464 →Price type
Allina Health Systems’s median price of $2.8k is 55% above the median hospital's median price ($1.8k), higher than 86% of the 1,221 hospitals reporting HCPCS L0464. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 10 payers, 29 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | UnitedHealthcare united healthcare (bdosv) facility · case rate · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 2 | Blue Cross Blue Shield bc pmap (b d o s v) facility · other · outpatient | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 3 | Ucare ucare pmap (abdmnorsuv) facility · percent of total billed charges · outpatientfrom % of charges | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 4 | Aetna allina aetna medicare (d) facility · fee schedule · outpatient | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
| 5 | Medicare medicare (d) facility · fee schedule · outpatient | $1.8k | $1.8k | — | — | — | $1.8k – $1.8k |
| 6 | Medicaid medicaid ma (d) facility · fee schedule · outpatient | $1.8k | $1.8k | — | — | — | $1.8k – $1.8k |
| 7 | Medica medica medicare (d) facility · fee schedule · outpatient | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 8 | Blue Cross Blue Shield bc medicare (d) facility · fee schedule · outpatient | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 9 | Blue Cross Blue Shield allina health blueprint (bdoshv) facility · other · outpatient | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
| 10 | Blue Cross Blue Shield bc state health plan (b d o s v) facility · other · outpatient | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
| 11 | Bcbs Mn bc premier (b d o s v) facility · other · outpatient | $2.4k | $2.4k | — | — | — | $2.4k – $2.4k |
| 12 | Aetna aetna elevate (bdosv) facility · percent of total billed charges · inpatientfrom % of charges | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 13 | Aetna aetna elevate (bdosv) facility · percent of total billed charges · outpatientfrom % of charges | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 14 | Aetna aetna performance (bdosv) facility · percent of total billed charges · inpatientfrom % of charges | $2.6k | $2.6k | — | — | — | $2.6k – $2.6k |
| 15 | Aetna aetna performance (bdosv) facility · percent of total billed charges · outpatientfrom % of charges | $2.6k | $2.6k | — | — | — | $2.6k – $2.6k |
| 16 | Blue Cross Blue Shield bc aehp (b d o s v) facility · other · outpatient | $2.8k | $2.8k | — | — | — | $2.8k – $2.8k |
| 17 | Medica medica dual solutions (b d v o s) facility · percent of total billed charges · outpatientfrom % of charges | $2.8k | $2.8k | — | — | — | $2.8k – $2.8k |
| 18 | Bcbs Mn bc high value/performance network (bdosv) facility · other · outpatient | $3.0k | $3.0k | — | — | — | $3.0k – $3.0k |
| 19 | Blue Cross Blue Shield bc aware/blue plus (b d o s v) facility · other · outpatient | $3.1k | $3.1k | — | — | — | $3.1k – $3.1k |
| 20 | Aetna aetna direct/indirect regional (bdosv) facility · percent of total billed charges · inpatientfrom % of charges | $3.3k | $3.3k | — | — | — | $3.3k – $3.3k |
| 21 | Aetna aetna direct/indirect regional (bdosv) facility · percent of total billed charges · outpatientfrom % of charges | $3.3k | $3.3k | — | — | — | $3.3k – $3.3k |
| 22 | Healthpartners hpi (bdov) facility · other · outpatient | $3.8k | $3.8k | — | — | — | $3.8k – $3.8k |
| 23 | Medica medica elect (b d o s v) facility · percent of total billed charges · outpatientfrom % of charges | $4.1k | $4.1k | — | — | — | $4.1k – $4.1k |
| 24 | Medica medica essentials (b d o s v) facility · percent of total billed charges · outpatientfrom % of charges | $4.3k | $4.3k | — | — | — | $4.3k – $4.3k |
| 25 | Medica medica mhps (bdosv) facility · percent of total billed charges · outpatientfrom % of charges | $4.3k | $4.3k | — | — | — | $4.3k – $4.3k |
Last updated: Jun 16, 2026
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