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Arkansas 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 $398,107 · 10th–90th $56–$891,2510%10%20%10th90th$398,107Professionalmedian $42 · 10th–90th $29–$590%20%40%10th90th$42$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $56.23 / $56.23
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $41.69 / $56.23
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218,776.16 / $524,807.46 / $954,992.59
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $72.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $57.54 / $93.33
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $41.69 / $61.66
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $85.11 / $100.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $45.71 / $67.61