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
Fa Brace Lso Custom
Ozark, MO
See all hospitals reporting HCPCS L0639 →Price type
Mercy Hospital Springfield’s median price of $1.4k is 10% below the median hospital's median price ($1.6k), higher than 27% of the 942 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: 15 payers, 30 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 | Medica hb sprg lebn medica exchange facility · percent of total billed charges · outpatientfrom % of charges | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 2 | Tricare hb sprg tricare facility · fee schedule · outpatient | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 3 | Ambetter hb sprg ambetter exchange mo facility · percent of total billed charges · outpatientfrom % of charges | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 4 | Anthem hb sprg anthem alliance facility · percent of total billed charges · outpatientfrom % of charges | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 5 | Anthem hb sprg anthem blue access facility · percent of total billed charges · outpatientfrom % of charges | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 6 | Blue Cross Blue Shield hb sprg anthem alliance facility · percent of total billed charges · outpatientfrom % of charges | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 7 | Blue Cross Blue Shield hb sprg anthem blue access facility · percent of total billed charges · outpatientfrom % of charges | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 8 | Blue Cross Blue Shield hb sprg anthem pathways exchange facility · percent of total billed charges · outpatientfrom % of charges | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 9 | Humana hb sprg humana facility · percent of total billed charges · outpatientfrom % of charges | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 10 | Aetna hb sprg medicare facility · fee schedule · outpatient | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 11 | Blue Cross Blue Shield hb sprg medicare facility · fee schedule · outpatient | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 12 | Cigna hb sprg medicare facility · fee schedule · outpatient | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 13 | Devoted hb sprg devoted health medicare advantage 104% w/seq facility · fee schedule · outpatient | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 14 | Humana hb sprg humana medicare 100% facility · fee schedule · outpatient | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 15 | Medica hb sprg medicare facility · fee schedule · outpatient | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 16 | Medicare hb sprg medicare facility · fee schedule · outpatient | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 17 | UnitedHealthcare hb sprg medicare facility · fee schedule · outpatient | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 18 | UnitedHealthcare hb sprg uhc mcr 100% facility · fee schedule · outpatient | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 19 | WellCare hb sprg & lebn wellcare mcr 103% facility · fee schedule · outpatient | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 20 | Optum hb sprg uhc all payer facility · percent of total billed charges · outpatientfrom % of charges | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 21 | UnitedHealthcare hb sprg uhc all payer facility · percent of total billed charges · outpatientfrom % of charges | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 22 | UnitedHealthcare hb sprg uhc individual exchange facility · percent of total billed charges · outpatientfrom % of charges | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 23 | UnitedHealthcare hb sprg uhc options ppo facility · percent of total billed charges · outpatientfrom % of charges | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 24 | Aetna hb sprg aetna commercial facility · percent of total billed charges · outpatientfrom % of charges | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 25 | Cigna hb sprg cigna hmo facility · percent of total billed charges · outpatientfrom % of charges | $2.0k | $2.0k | — | — | — | $2.0k – $2.0k |
Last updated: Jun 4, 2026
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