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Georgia 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 $65 · 10th–90th $38–$2400%10%20%10th90th$65Professionalmedian $50 · 10th–90th $33–$890%20%10th90th$50$0.1$0.5$2.0$10.0$50.0$200.0$1.0K

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
$38.02 / $38.02 / $102.33
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $38.90 / $70.79
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $154.88 / $239.88
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $85.11 / $112.20
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $63.10
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $53.70
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 / $87.10
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $64.57 / $177.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.18 / $44.67 / $64.57
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $48.98 / $75.86