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LSO, Flexible, Off-the-Shelf

Nationwide rates for HCPCS L0628

Lumbar-sacral orthosis (LSO), flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to T-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf

Rates data updated July 2026.

Facilitymedian $56 · 10th–90th $34$1820%20%40%10th90th$56Professionalmedian $49 · 10th–90th $30$830%20%40%10th90th$49$0.1$2.0$50.0$1.0K$20.0K$500.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$29.51
Median
$43.65
Typical High
$77.62
Aetna
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$41.69
Typical High
$69.18
BCBS
Setting
Facility
Modifier
Global
Typical Low
$41.69
Median
$54.95
Typical High
$131.83
BCBS
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$54.95
Typical High
$100.00
Cigna
Setting
Facility
Modifier
Global
Typical Low
$57.54
Median
$57.54
Typical High
$251.19
Cigna
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$41.69
Typical High
$91.20
United
Setting
Facility
Modifier
Global
Typical Low
$34.67
Median
$52.48
Typical High
$100.00
United
Setting
Professional
Modifier
Global
Typical Low
$33.11
Median
$48.98
Typical High
$75.86