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
Puyallup, WA
See all hospitals reporting HCPCS L0649 →Price type
Good Samaritan Hospital’s median price of $162 is 27% below the median hospital's median price ($223), higher than 18% 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: 9 payers, 13 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 | Aetna medadvantage fee schedule · outpatient | $99.04 | $99.04 | $99.04 – $99.04 |
| 2 | Regence medadvantage fee schedule · outpatient | $99.04 | $99.04 | $99.04 – $99.04 |
| 3 | UnitedHealthcare medadvantage fee schedule · outpatient | $100.00 | $100.00 | $100.00 – $100.00 |
| 4 | Molina medadvantage fee schedule · outpatient | $100.97 | $100.97 | $100.97 – $100.97 |
| 5 | WellCare medadvantage fee schedule · outpatient | $100.97 | $100.97 | $100.97 – $100.97 |
| 6 | Aetna all commercial plans fee schedule · outpatient | $128.02 | $128.02 | $128.02 – $128.02 |
| 7 | Cigna all commercial plans fee schedule · outpatient | $133.76 | $133.76 | $133.76 – $133.76 |
| 8 | Premera prime fee schedule · outpatient | $166.97 | $166.97 | $166.97 – $166.97 |
| 9 | Premera signature fee schedule · outpatient | $166.97 | $166.97 | $166.97 – $166.97 |
| 10 | Ambetter coordinated care exchange fee schedule · outpatient | $192.32 | $192.32 | $192.32 – $192.32 |
| 11 | Premera other commercial plans fee schedule · outpatient | $204.07 | $204.07 | $204.07 – $204.07 |
| 12 | Premera hmo fee schedule · outpatient | $239.71 | $239.71 | $239.71 – $239.71 |
| 13 | Kaiser ppo fee schedule · outpatient | $693.67 | $693.67 | $693.67 – $693.67 |
Last updated: Aug 27, 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.