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LO, Flexible, Off-the-Shelf

South Dakota rates for HCPCS L0625

Lumbar orthosis (LO), flexible, provides lumbar support, posterior extends from L-1 to below L-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf

Rates data updated July 2026.

How much does LO, Flexible, Off-the-Shelf cost?

$40.74

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $40.74 for this service. The price depends on where it is billed: about $40.74 from a physician practice, and about $53.70 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 8 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$40.74$33.88 to $48.98
FacilityA hospital or hospital-owned outpatient department$53.70$38.02 to $63.10

How much rates vary

Facilitymedian $54 · 10th to 90th $37 to $83Professionalmedian $41 · 10th to 90th $30 to $59
$20$50$100$200facility $54professional $41

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$48.98
Median
$48.98
Typical High
$48.98
Aetna
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$33.88
Typical High
$37.15
Avera
Setting
Facility
Modifier
Global
Typical Low
$57.54
Median
$57.54
Typical High
$57.54
Cigna
Setting
Facility
Modifier
Global
Typical Low
$38.02
Median
$38.02
Typical High
$60.26
Cigna
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$47.86
Typical High
$58.88
Medica
Setting
Facility
Modifier
Global
Typical Low
$37.15
Median
$56.23
Typical High
$102.33
Medica
Setting
Professional
Modifier
Global
Typical Low
$26.92
Median
$42.66
Typical High
$275.42
Midlands
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$58.88
Typical High
$60.26
Midlands
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$60.26
Typical High
$60.26
Midlands
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$60.26
Typical High
$120.23
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$45.71
Typical High
$56.23
United
Setting
Facility
Modifier
Global
Typical Low
$33.11
Median
$34.67
Typical High
$48.98
United
Setting
Professional
Modifier
Global
Typical Low
$7.08
Median
$42.66
Typical High
$56.23
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$53.70
Typical High
$53.70

Where South Dakota sits

The same service costs 3.5 times more in Hawaii than in Washington, DC. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

South Dakota· 6th of 51

$40.74

HI $63.10DC $18.20

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.