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
BRACE BACK T-LSO CUSTOM
Troy, NY
See all hospitals reporting HCPCS L0486 →Price type
Samaritan Hospital’s median price of $1.9k is 24% below the median hospital's median price ($2.5k), higher than 7% of the 1,096 hospitals reporting HCPCS L0486. 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, 26 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 aetna facility · percent of total billed charges · bothfrom % of charges | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 2 | Blue Cross Blue Shield blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 3 | Blue Cross Blue Shield blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 4 | Carefirst blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 5 | Carefirst blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 6 | Excellus blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 7 | Highmark blue shield of ne new york ascend facility · percent of total billed charges · bothfrom % of charges | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 8 | Highmark blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 9 | Highmark blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 10 | Medical Mutual aetna facility · percent of total billed charges · bothfrom % of charges | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 11 | Premera blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 12 | Regence blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 13 | UnitedHealthcare uhc essential plan medicaid facility · percent of total billed charges · bothfrom % of charges | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 14 | UnitedHealthcare united healthcare medicaid harp chip facility · percent of total billed charges · bothfrom % of charges | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 15 | Wellmark blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 16 | Wellmark blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 17 | UnitedHealthcare united healthcare facility · percent of total billed charges · bothfrom % of charges | $3.7k | $3.7k | $1.1k | 29% | — | $2.6k – $4.7k |
| 18 | First Health first health facility · percent of total billed charges · bothfrom % of charges | $3.8k | $3.8k | — | — | — | $3.8k – $3.8k |
| 19 | Cigna cigna facility · percent of total billed charges · bothfrom % of charges | $4.0k | $4.0k | — | — | — | $4.0k – $4.0k |
| 20 | MultiPlan beech street facility · percent of total billed charges · bothfrom % of charges | $4.3k | $4.3k | — | — | — | $4.3k – $4.3k |
| 21 | MultiPlan multiplan facility · percent of total billed charges · bothfrom % of charges | $4.3k | $4.3k | — | — | — | $4.3k – $4.3k |
| 22 | Phcs multiplan facility · percent of total billed charges · bothfrom % of charges | $4.3k | $4.3k | — | — | — | $4.3k – $4.3k |
| 23 | Anthem empire medicaid facility · percent of total billed charges · bothfrom % of charges | $4.7k | $4.7k | — | — | — | $4.7k – $4.7k |
| 24 | Anthem empire medicaid essential 1 2 3 4 facility · percent of total billed charges · bothfrom % of charges | $4.7k | $4.7k | — | — | — | $4.7k – $4.7k |
| 25 | Excellus empire medicaid facility · percent of total billed charges · bothfrom % of charges | $4.7k | $4.7k | — | — | — | $4.7k – $4.7k |
Last updated: Mar 31, 2026
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