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
Sio rig pnl pelv/sac pre ots
Cypress, TX
See all hospitals reporting HCPCS L0623 →Price type
Houston Methodist Cypress Hospital’s median price of $136 is about the same as the median hospital's median price ($136), higher than 48% of the 831 hospitals reporting HCPCS L0623. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 7 payers, 8 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 medicare managed care - hmo fee schedule · outpatient | $129 | $129 | — | — | — | $129 – $129 |
| 2 | Aetna medicare managed care - hmo/ppo fee schedule · outpatient | $131 | $131 | — | — | — | $131 – $131 |
| 3 | UnitedHealthcare medicare managed care - hmo fee schedule · outpatient | $132 | $132 | — | — | — | $132 – $132 |
| 4 | Cigna texas healthspring medicare managed care - hmo/ppo fee schedule · outpatient | $133 | $133 | — | — | — | $133 – $133 |
| 5 | Molina advantage medicare managed care plan fee schedule · outpatient | $136 | $136 | — | — | — | $136 – $136 |
| 6 | Devoted medicare managed care - hmo fee schedule · outpatient | $138 | $138 | — | — | — | $138 – $138 |
| 7 | Optum transplant medicare managed care plan fee schedule · outpatient | $252 | $252 | — | — | — | $252 – $252 |
| 8 | Molina exchange fee schedule · outpatient | $259 | $259 | — | — | — | $259 – $259 |
Last updated: Apr 1, 2026
See Sacroiliac support brace with rigid panels pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.