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Washington, DC 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 $27 · 10th–90th $27–$1200%50%90th$27Professionalmedian $34 · 10th–90th $27–$690%20%10th90th$34$50.0$100.0

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
Facility
Modifier
Typical Low / Median / Typical High
$26.92 / $26.92 / $40.74
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $33.88 / $69.18
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $54.95 / $54.95
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 / $61.66
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $48.98 / $141.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $120.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $48.98 / $63.10