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 ULTRALIGN LSO L/P 15D XXL
Arlington, TX
See all hospitals reporting HCPCS L0650 →Price type
AMH Cath Labs LLC’s median price of $635 is 31% below the median hospital's median price ($922), higher than 21% of the 1,090 hospitals reporting HCPCS L0650. 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 | $94 | $81 | $18 | 23% | — | $55 – $94 |
| 2 | UnitedHealthcare managed medicaid percent of total billed charges · outpatientfrom % of charges | $94 | $81 | $18 | 23% | — | $55 – $94 |
| 3 | WellCare managed medicaid percent of total billed charges · outpatientfrom % of charges | $99 | $85 | $19 | 23% | — | $58 – $99 |
| 4 | Molina managed medicaid percent of total billed charges · outpatientfrom % of charges | $102 | $88 | $20 | 23% | — | $60 – $102 |
| 5 | Aetna managed medicaid percent of total billed charges · outpatientfrom % of charges | $104 | $89 | $20 | 23% | — | $61 – $104 |
| 6 | Blue Cross Blue Shield exchange percent of total billed charges · outpatientfrom % of charges | $328 | $283 | $64 | 23% | — | $193 – $328 |
| 7 | Aetna whole health percent of total billed charges · outpatientfrom % of charges | $435 | $375 | $85 | 23% | — | $255 – $435 |
| 8 | Blue Cross Blue Shield hmo percent of total billed charges · outpatientfrom % of charges | $530 | $457 | $103 | 23% | — | $311 – $530 |
| 9 | Aetna commercial percent of total billed charges · outpatientfrom % of charges | $580 | $500 | $113 | 23% | — | $340 – $580 |
| 10 | Cigna oap/hmo percent of total billed charges · outpatientfrom % of charges | $585 | $505 | $114 | 23% | — | $344 – $585 |
| 11 | Blue Cross Blue Shield ppo percent of total billed charges · outpatientfrom % of charges | $589 | $508 | $115 | 23% | — | $346 – $589 |
| 12 | Blue Cross Blue Shield traditional percent of total billed charges · outpatientfrom % of charges | $589 | $508 | $115 | 23% | — | $346 – $589 |
| 13 | UnitedHealthcare all payer percent of total billed charges · outpatientfrom % of charges | $667 | $576 | $130 | 23% | — | $392 – $667 |
| 14 | UnitedHealthcare ppo percent of total billed charges · outpatientfrom % of charges | $706 | $609 | $137 | 23% | — | $414 – $706 |
| 15 | Phcs ppo percent of total billed charges · outpatientfrom % of charges | $736 | $635 | $143 | 23% | — | $432 – $736 |
| 16 | Cigna ppo percent of total billed charges · outpatientfrom % of charges | $738 | $636 | $144 | 23% | — | $433 – $738 |
| 17 | Aetna asa percent of total billed charges · outpatientfrom % of charges | $742 | $640 | $145 | 23% | — | $436 – $742 |
| 18 | Aetna coventry percent of total billed charges · outpatientfrom % of charges | $742 | $640 | $145 | 23% | — | $436 – $742 |
| 19 | Phcs ppo percent of total billed charges · inpatientfrom % of charges | $789 | $680 | $154 | 23% | — | $463 – $789 |
| 20 | MultiPlan commercial percent of total billed charges · inpatientfrom % of charges | $921 | $794 | $179 | 23% | — | $541 – $921 |
| 21 | MultiPlan commercial percent of total billed charges · outpatientfrom % of charges | $921 | $794 | $179 | 23% | — | $541 – $921 |
| 22 | Cigna indemnity percent of total billed charges · inpatientfrom % of charges | $997 | $859 | $194 | 23% | — | $585 – $997 |
| 23 | Cigna indemnity percent of total billed charges · outpatientfrom % of charges | $997 | $859 | $194 | 23% | — | $585 – $997 |
| 24 | Blue Cross Blue Shield medicare advantage case rate · outpatient | $870 | $870 | — | — | — | $870 – $870 |
| 25 | Humana medicare advantage case rate · outpatient | $905 | $905 | — | — | — | $905 – $905 |
Last updated: Apr 21, 2026
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