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
BRACE TLSO 4MOD SACRO-SCAP PRE
Arlington, TX
See all hospitals reporting HCPCS L0464 →Price type
AMH Cath Labs LLC’s median price of $829 is 55% below the median hospital's median price ($1.8k), higher than 14% of the 1,216 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, 31 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 | Blue Cross Blue Shield managed medicaid percent of total billed charges · outpatientfrom % of charges | $88 | $198 | $193 | 97% | — | $85 – $532 |
| 2 | UnitedHealthcare managed medicaid percent of total billed charges · outpatientfrom % of charges | $88 | $198 | $193 | 97% | — | $85 – $532 |
| 3 | WellCare managed medicaid percent of total billed charges · outpatientfrom % of charges | $92 | $208 | $203 | 97% | — | $89 – $559 |
| 4 | Molina managed medicaid percent of total billed charges · outpatientfrom % of charges | $95 | $214 | $208 | 97% | — | $92 – $575 |
| 5 | Aetna managed medicaid percent of total billed charges · outpatientfrom % of charges | $96 | $218 | $212 | 97% | — | $93 – $585 |
| 6 | Blue Cross Blue Shield exchange percent of total billed charges · outpatientfrom % of charges | $305 | $690 | $672 | 97% | — | $295 – $1.9k |
| 7 | Aetna whole health percent of total billed charges · outpatientfrom % of charges | $404 | $914 | $890 | 97% | — | $391 – $2.5k |
| 8 | Blue Cross Blue Shield hmo percent of total billed charges · outpatientfrom % of charges | $492 | $1.1k | $1.1k | 97% | — | $476 – $3.0k |
| 9 | Aetna commercial percent of total billed charges · outpatientfrom % of charges | $539 | $1.2k | $1.2k | 97% | — | $522 – $3.3k |
| 10 | Cigna oap/hmo percent of total billed charges · outpatientfrom % of charges | $544 | $1.2k | $1.2k | 97% | — | $527 – $3.3k |
| 11 | Blue Cross Blue Shield ppo percent of total billed charges · outpatientfrom % of charges | $547 | $1.2k | $1.2k | 97% | — | $530 – $3.3k |
| 12 | Blue Cross Blue Shield traditional percent of total billed charges · outpatientfrom % of charges | $547 | $1.2k | $1.2k | 97% | — | $530 – $3.3k |
| 13 | UnitedHealthcare all payer percent of total billed charges · outpatientfrom % of charges | $620 | $1.4k | $1.4k | 97% | — | $601 – $3.8k |
| 14 | UnitedHealthcare ppo percent of total billed charges · outpatientfrom % of charges | $656 | $1.5k | $1.4k | 97% | — | $635 – $4.0k |
| 15 | Phcs ppo percent of total billed charges · outpatientfrom % of charges | $684 | $1.5k | $1.5k | 97% | — | $662 – $4.2k |
| 16 | Cigna ppo percent of total billed charges · outpatientfrom % of charges | $686 | $1.6k | $1.5k | 97% | — | $664 – $4.2k |
| 17 | Aetna asa percent of total billed charges · outpatientfrom % of charges | $690 | $1.6k | $1.5k | 97% | — | $668 – $4.2k |
| 18 | Aetna coventry percent of total billed charges · outpatientfrom % of charges | $690 | $1.6k | $1.5k | 97% | — | $668 – $4.2k |
| 19 | Phcs ppo percent of total billed charges · inpatientfrom % of charges | $733 | $1.7k | $1.6k | 97% | — | $710 – $4.5k |
| 20 | Blue Cross Blue Shield medicare advantage case rate · outpatient | $1.8k | $1.8k | — | — | — | $1.8k – $1.8k |
| 21 | Humana medicare advantage case rate · outpatient | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 22 | Humana medicare advantage ppo case rate · outpatient | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 23 | Molina medicare advantage case rate · outpatient | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 24 | WellCare medicare advantage hmo case rate · outpatient | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 25 | MultiPlan commercial percent of total billed charges · inpatientfrom % of charges | $856 | $1.9k | $1.9k | 97% | — | $829 – $5.2k |
Last updated: Apr 21, 2026
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