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
Ulm, MN
See all hospitals reporting HCPCS L0464 →Price type
Allina Health Systems’s median price of $2.8k is 53% above the median hospital's median price ($1.8k), higher than 85% 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: 9 payers, 24 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 | Ucare ucare pmap (abdmnorsuv) facility · percent of total billed charges · outpatientfrom % of charges | $845 | $845 | — | — | — | $845 – $845 |
| 2 | Bcbs Mn bc pmap (n) facility · other · outpatient | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 3 | Medica medica pmap (n) facility · percent of total billed charges · outpatientfrom % of charges | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 4 | Aetna allina aetna medicare (n) facility · fee schedule · outpatient | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
| 5 | Medicare medicare (n) facility · fee schedule · outpatient | $1.8k | $1.8k | — | — | — | $1.8k – $1.8k |
| 6 | Medicaid medicaid ma (n) facility · other · outpatient | $1.8k | $1.8k | — | — | — | $1.8k – $1.8k |
| 7 | Medica medica medicare (r) facility · fee schedule · outpatient | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 8 | Medica medica dual solutions (r) facility · percent of total billed charges · outpatientfrom % of charges | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 9 | Blue Cross Blue Shield bc medicare (n) facility · fee schedule · outpatient | $2.0k | $2.0k | — | — | — | $2.0k – $2.0k |
| 10 | Aetna aetna elevate (n r) facility · percent of total billed charges · inpatientfrom % of charges | $2.6k | $2.6k | — | — | — | $2.6k – $2.6k |
| 11 | Aetna aetna elevate (n r) facility · percent of total billed charges · outpatientfrom % of charges | $2.6k | $2.6k | — | — | — | $2.6k – $2.6k |
| 12 | Bcbs Mn bc state health plan (n) facility · other · outpatient | $2.6k | $2.6k | — | — | — | $2.6k – $2.6k |
| 13 | Aetna aetna performance (n r) facility · percent of total billed charges · inpatientfrom % of charges | $2.8k | $2.8k | — | — | — | $2.8k – $2.8k |
| 14 | Aetna aetna performance (n r) facility · percent of total billed charges · outpatientfrom % of charges | $2.8k | $2.8k | — | — | — | $2.8k – $2.8k |
| 15 | Medica medica ubh pmap (n) facility · percent of total billed charges · outpatientfrom % of charges | $3.4k | $3.4k | — | — | — | $3.4k – $3.4k |
| 16 | Bcbs Mn bc premier(n) facility · other · outpatient | $3.4k | $3.4k | — | — | — | $3.4k – $3.4k |
| 17 | Cigna hpi cigna (n) facility · other · outpatient | $3.4k | $3.4k | — | — | — | $3.4k – $3.4k |
| 18 | First Health first health (abdmnosurv) facility · percent of total billed charges · inpatientfrom % of charges | $3.5k | $3.5k | — | — | — | $3.5k – $3.5k |
| 19 | First Health first health (abdmnosurv) facility · percent of total billed charges · outpatientfrom % of charges | $3.5k | $3.5k | — | — | — | $3.5k – $3.5k |
| 20 | Medica medica ubh (n) facility · percent of total billed charges · outpatientfrom % of charges | $3.5k | $3.5k | — | — | — | $3.5k – $3.5k |
| 21 | Aetna aetna direct/indirect network (n r) facility · percent of total billed charges · inpatientfrom % of charges | $3.6k | $3.6k | — | — | — | $3.6k – $3.6k |
| 22 | Aetna aetna direct/indirect network (n r) facility · percent of total billed charges · outpatientfrom % of charges | $3.6k | $3.6k | — | — | — | $3.6k – $3.6k |
| 23 | Blue Cross Blue Shield bc aehp (n) facility · other · outpatient | $4.0k | $4.0k | — | — | — | $4.0k – $4.0k |
| 24 | Bcbs Mn bc high value/performance network (n) facility · other · outpatient | $4.3k | $4.3k | — | — | — | $4.3k – $4.3k |
Last updated: Jun 16, 2026
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