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
Lso sc r pos/lat pnl pre ots
Maple Grove, MN
See all hospitals reporting HCPCS L0649 →Price type
Fairview Maple Grove Surgery Center’s median price of $250 is 12% above the median hospital's median price ($223), higher than 69% of the 821 hospitals reporting HCPCS L0649. 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, 22 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.
Filter by billing methodology
Filter by billing class
| # | ||||
|---|---|---|---|---|
| 1 | Medica accessability fee schedule · both | $206.46 | $206.46 | $206.46 – $206.46 |
| 2 | Medica medicaid fee schedule · both | $206.46 | $206.46 | $206.46 – $206.46 |
| 3 | Blue Cross Blue Shield medicaid fee schedule · both | $224.89 | $224.89 | $224.89 – $224.89 |
| 4 | Medica ma non-snp fee schedule · both | $225.42 | $225.42 | $225.42 – $225.42 |
| 5 | Medica ma snp fee schedule · both | $225.42 | $225.42 | $225.42 – $225.42 |
| 6 | Medica prime solution fee schedule · both | $225.42 | $225.42 | $225.42 – $225.42 |
| 7 | Medica vantage fee schedule · both | $225.42 | $225.42 | $225.42 – $225.42 |
| 8 | Ucare mhcp fee schedule · both | $231.64 | $231.64 | $231.64 – $231.64 |
| 9 | Blue Cross Blue Shield federal fee schedule · outpatient | $242.75 | $242.75 | $242.75 – $242.75 |
| 10 | Blue Cross Blue Shield commercial fee schedule · outpatient | $247.12 | $247.12 | $247.12 – $247.12 |
| 11 | Blue Cross Blue Shield medicaid fee schedule · outpatient | $247.12 | $247.12 | $247.12 – $247.12 |
| 12 | Blue Cross Blue Shield federal fee schedule · both | $260.30 | $260.30 | $260.30 – $260.30 |
| 13 | Blue Cross Blue Shield commercial fee schedule · both | $264.99 | $264.99 | $264.99 – $264.99 |
| 14 | Cigna commercial fee schedule · both | $277.02 | $277.02 | $252.93 – $301.11 |
| 15 | Ucare ifp with fairview fee schedule · outpatient | $376.52 | $376.52 | $376.52 – $376.52 |
| 16 | Medica bold fee schedule · both | $389.28 | $389.28 | $389.28 – $389.28 |
| 17 | Medica choice without / elect fee schedule · both | $432.53 | $432.53 | $432.53 – $432.53 |
| 18 | Medica city of st paul / essential uplan fee schedule · both | $432.53 | $432.53 | $432.53 – $432.53 |
| 19 | Medica choice with fee schedule · both | $447.61 | $447.61 | $447.61 – $447.61 |
| 20 | Ucare ifp fee schedule · outpatient | $501.88 | $501.88 | $501.88 – $501.88 |
| 21 | Cigna commercial fee schedule · outpatient | $581.74 | $581.74 | $531.15 – $632.32 |
| 22 | UnitedHealthcare commercial fee schedule · both | $661.00 | $661.00 | $661.00 – $661.00 |
Last updated: May 18, 2026
See Lumbar-sacral back brace with rigid posterior panels pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.