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
HC VISTA LSO 639 LSO 4 PANEL, EA
Buda, TX
See all hospitals reporting HCPCS L0639 →Price type
Baylor Scott & White Medical Center - Buda’s median price of $858 is 46% below the median hospital's median price ($1.6k), higher than 5% of the 946 hospitals reporting HCPCS L0639. 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, 28 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 | Superior Healthplan medicaid facility · percent of total billed charges · outpatientfrom % of charges | $158 | $158 | — | — | — | $158 – $158 |
| 2 | UnitedHealthcare medicaid/chip facility · percent of total billed charges · outpatientfrom % of charges | $170 | $170 | — | — | — | $170 – $170 |
| 3 | Blue Cross Blue Shield blue advantage facility · percent of total billed charges · inpatientfrom % of charges | $436 | $436 | — | — | — | $436 – $436 |
| 4 | Baylor Scott White Health Plan bsw premier - large group/bsw premier direct to employer (rate 1)/bswh employee facility · percent of total billed charges · inpatientfrom % of charges | $595 | $595 | — | — | — | $595 – $595 |
| 5 | Baylor Scott White Health Plan bsw premier - large group/bsw premier direct to employer (rate 1)/bswh employee facility · percent of total billed charges · outpatientfrom % of charges | $602 | $602 | — | — | — | $602 – $602 |
| 6 | Baylor Scott White Health Plan bsw plus - large group/bsw premier direct to employer (rate 2) facility · percent of total billed charges · inpatientfrom % of charges | $700 | $700 | — | — | — | $700 – $700 |
| 7 | Baylor Scott White Health Plan bsw plus - large group/bsw premier direct to employer (rate 2) facility · percent of total billed charges · outpatientfrom % of charges | $708 | $708 | — | — | — | $708 – $708 |
| 8 | Aetna commercial facility · percent of total billed charges · outpatientfrom % of charges | $726 | $726 | — | — | — | $726 – $726 |
| 9 | Blue Cross Blue Shield blue advantage facility · percent of total billed charges · outpatientfrom % of charges | $766 | $766 | — | — | — | $766 – $766 |
| 10 | Cigna local plus facility · percent of total billed charges · inpatientfrom % of charges | $766 | $766 | — | — | — | $766 – $766 |
| 11 | Cigna local plus facility · percent of total billed charges · outpatientfrom % of charges | $766 | $766 | — | — | — | $766 – $766 |
| 12 | Aetna commercial facility · percent of total billed charges · inpatientfrom % of charges | $779 | $779 | — | — | — | $779 – $779 |
| 13 | Humana commercial hmo facility · percent of total billed charges · inpatientfrom % of charges | $858 | $858 | — | — | — | $858 – $858 |
| 14 | Humana commercial hmo facility · percent of total billed charges · outpatientfrom % of charges | $858 | $858 | — | — | — | $858 – $858 |
| 15 | Cigna hmo/ppo facility · percent of total billed charges · inpatientfrom % of charges | $898 | $898 | — | — | — | $898 – $898 |
| 16 | Cigna hmo/ppo facility · percent of total billed charges · outpatientfrom % of charges | $898 | $898 | — | — | — | $898 – $898 |
| 17 | UnitedHealthcare commercial facility · percent of total billed charges · outpatientfrom % of charges | $913 | $913 | — | — | — | $913 – $913 |
| 18 | Blue Cross Blue Shield blue essentials (hmo) facility · percent of total billed charges · inpatientfrom % of charges | $924 | $924 | — | — | — | $924 – $924 |
| 19 | Blue Cross Blue Shield blue essentials (hmo) facility · percent of total billed charges · outpatientfrom % of charges | $924 | $924 | — | — | — | $924 – $924 |
| 20 | Blue Cross Blue Shield blue premier/high performance network/my bluehealth facility · percent of total billed charges · inpatientfrom % of charges | $924 | $924 | — | — | — | $924 – $924 |
| 21 | Blue Cross Blue Shield blue premier/high performance network/my bluehealth facility · percent of total billed charges · outpatientfrom % of charges | $924 | $924 | — | — | — | $924 – $924 |
| 22 | Blue Cross Blue Shield bluechoice (ppo) facility · percent of total billed charges · inpatientfrom % of charges | $924 | $924 | — | — | — | $924 – $924 |
| 23 | Blue Cross Blue Shield bluechoice (ppo) facility · percent of total billed charges · outpatientfrom % of charges | $924 | $924 | — | — | — | $924 – $924 |
| 24 | First Health ppo facility · percent of total billed charges · inpatientfrom % of charges | $924 | $924 | — | — | — | $924 – $924 |
| 25 | First Health ppo facility · percent of total billed charges · outpatientfrom % of charges | $924 | $924 | — | — | — | $924 – $924 |
Last updated: Jun 13, 2026
See Lumbar-sacral back brace with rigid shell pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.