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LSO, Flexible, Off-the-Shelf

Colorado 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 $43 · 10th–90th $23$1000%10%20%10th90th$43Professionalmedian $40 · 10th–90th $23$560%20%10th90th$40$0.1$0.5$2.0$10.0$50.0$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
Setting
Facility
Modifier
Global
Typical Low
$23.44
Median
$23.44
Typical High
$40.74
Aetna
Setting
Professional
Modifier
Global
Typical Low
$23.44
Median
$33.11
Typical High
$53.70
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$42.66
Median
$51.29
Typical High
$91.20
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$29.51
Median
$54.95
Typical High
$54.95
Cigna
Setting
Facility
Modifier
Global
Typical Low
$57.54
Median
$57.54
Typical High
$57.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$41.69
Typical High
$61.66
Denver HMP
Setting
Facility
Modifier
Global
Typical Low
$28.84
Median
$50.12
Typical High
$109.65
Denver HMP
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$28.84
Typical High
$28.84
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$25.70
Median
$42.66
Typical High
$151.36
Select Health
Setting
Facility
Modifier
Global
Typical Low
$44.67
Median
$79.43
Typical High
$89.13
Select Health
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$53.70
Typical High
$85.11
United
Setting
Facility
Modifier
Global
Typical Low
$33.88
Median
$44.67
Typical High
$56.23
United
Setting
Professional
Modifier
Global
Typical Low
$33.11
Median
$44.67
Typical High
$67.61