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Alaska 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

Facilitymedian $29 · 10th–90th $29–$910%50%90th$29Professionalmedian $51 · 10th–90th $29–$1070%10%20%10th90th$51$50.0$100.0$200.0

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
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $50.12 / $81.28
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $57.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $41.69 / $102.33
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.84 / $42.66 / $91.20
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$27.54 / $91.20 / $144.54
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$41.69 / $91.20 / $95.50
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $91.20 / $95.50
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.84 / $28.84 / $81.28
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $60.26 / $72.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$44.67 / $44.67 / $47.86
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $74.13 / $245.47