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
Tlso flex trunk/thor pre ots
Devils Lake, ND
See all hospitals reporting HCPCS L0450 →Price type
Altru Hospital Devils Lake’s median price of $169 is 11% above the median hospital's median price ($152), higher than 56% of the 1,005 hospitals reporting HCPCS L0450. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 5 payers, 10 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 | Medica medicaid managed care plan facility · fee schedule · outpatient | $47 | $47 | — | — | — | $47 – $47 |
| 2 | Medica medicaid managed care plan – hmo facility · fee schedule · outpatient | $47 | $47 | — | — | — | $47 – $47 |
| 3 | Medica medicare managed care plan facility · fee schedule · outpatient | $85 | $85 | — | — | — | $85 – $85 |
| 4 | Medica all commercial plans facility · fee schedule · outpatient | $139 | $139 | — | — | — | $139 – $139 |
| 5 | Aetna medicare managed care plan facility · fee schedule · outpatient | $142 | $142 | — | — | — | $142 – $142 |
| 6 | Blue Cross Blue Shield all commercial plans facility · fee schedule · outpatient | $169 | $169 | — | — | — | $169 – $169 |
| 7 | Blue Cross Blue Shield medicaid managed care plan facility · fee schedule · outpatient | $169 | $169 | — | — | — | $169 – $169 |
| 8 | Sanford Health Plan all commercial plans facility · fee schedule · outpatient | $195 | $195 | $28 | 15% | — | $166 – $223 |
| 9 | Aetna all commercial plans facility · fee schedule · outpatient | $203 | $203 | $53 | 26% | — | $149 – $256 |
| 10 | UnitedHealthcare all commercial plans facility · fee schedule · outpatient | $279 | $279 | — | — | — | $279 – $279 |
Last updated: Mar 1, 2026
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