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I've used this this cushion for over two years. Yes, it is expensive (maybe too expensive). That's why the three stars. But the end result is it's helped me with my bulging lower back disc, after I removed the foam cutout.
One thing: the memory foam becomes VERY hard after being left overnight in the car and the temperature was 50 degrees or below.
I had an emergency Hemr$$$d flare up and it was impossible to sit on my office chair. I ran to the nearest store and found this to be only acceptable fix. Tried other cushions and sub $200 seating solutions. I did get sticker shock at $160 and have the 30day return policy, but I think I am gonna keep it. I sit 1/3rd of my life on this chair so its a good investment. My weight - 255 lbs. PS it worked better with the removable insert in place.