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
River Falls, WI
See all hospitals reporting HCPCS L0464 →Price type
Allina Health Systems’s median price of $3.4k is 83% above the median hospital's median price ($1.8k), higher than 92% 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: 8 payers, 20 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 | Bcbs Mn bc pmap (r) facility · fee schedule · outpatient | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 2 | Ucare ucare pmap (abdmnorsuv) facility · percent of total billed charges · outpatientfrom % of charges | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 3 | Medica medica pmap (r) facility · percent of total billed charges · outpatientfrom % of charges | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 4 | Aetna allina aetna medicare (r) facility · fee schedule · outpatient | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
| 5 | Medicare medicare (r) facility · fee schedule · outpatient | $1.8k | $1.8k | — | — | — | $1.8k – $1.8k |
| 6 | Medicaid medicaid ma (r) facility · fee schedule · outpatient | $1.8k | $1.8k | — | — | — | $1.8k – $1.8k |
| 7 | Blue Cross Blue Shield bc medicare (r) facility · fee schedule · outpatient | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 8 | Medica medica medicare (r) facility · fee schedule · outpatient | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 9 | Medica medica dual solutions (r) facility · percent of total billed charges · outpatientfrom % of charges | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 10 | Bcbs Mn bc state health plan (r) facility · fee schedule · outpatient | $2.6k | $2.6k | — | — | — | $2.6k – $2.6k |
| 11 | Bcbs Mn bc premier (r) facility · fee schedule · outpatient | $3.3k | $3.3k | — | — | — | $3.3k – $3.3k |
| 12 | Aetna aetna elevate (n r) facility · percent of total billed charges · inpatientfrom % of charges | $3.4k | $3.4k | — | — | — | $3.4k – $3.4k |
| 13 | Aetna aetna elevate (n r) facility · percent of total billed charges · outpatientfrom % of charges | $3.5k | $3.5k | — | — | — | $3.5k – $3.5k |
| 14 | Aetna aetna performance (n r) facility · percent of total billed charges · inpatientfrom % of charges | $3.7k | $3.7k | — | — | — | $3.7k – $3.7k |
| 15 | Aetna aetna performance (n r) facility · percent of total billed charges · outpatientfrom % of charges | $3.7k | $3.7k | — | — | — | $3.7k – $3.7k |
| 16 | Blue Cross Blue Shield bc aehp (r) facility · fee schedule · outpatient | $3.9k | $3.9k | — | — | — | $3.9k – $3.9k |
| 17 | First Health first health (abdmnosurv) facility · percent of total billed charges · inpatientfrom % of charges | $4.7k | $4.7k | — | — | — | $4.7k – $4.7k |
| 18 | First Health first health (abdmnosurv) facility · percent of total billed charges · outpatientfrom % of charges | $4.7k | $4.7k | — | — | — | $4.7k – $4.7k |
| 19 | Aetna aetna direct/indirect network (n r) facility · percent of total billed charges · inpatientfrom % of charges | $4.7k | $4.7k | — | — | — | $4.7k – $4.7k |
| 20 | Aetna aetna direct/indirect network (n r) facility · percent of total billed charges · outpatientfrom % of charges | $4.8k | $4.8k | — | — | — | $4.8k – $4.8k |
Last updated: Jun 15, 2026
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