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LSO, Flexible, Off-the-Shelf

Hawaii 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 October 2026.

How much does LSO, Flexible, Off-the-Shelf cost?

$95.50

Typical negotiated rate. In Hawaii, October 2026.

Insurers have agreed to pay about $95.50 for this service. Most negotiated rates run $77.62 to $100.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $78 · 10th to 90th $58 to $78Professionalmedian $95 · 10th to 90th $66 to $102
$100facility $78professional $95

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$33.88
Median
$33.88
Typical High
$33.88
Cigna
Setting
Facility
Modifier
None
Typical Low
$57.54
Median
$77.62
Typical High
$77.62
Cigna
Setting
Professional
Modifier
None
Typical Low
$102.33
Median
$102.33
Typical High
$102.33
HMSA
Setting
Professional
Modifier
None
Typical Low
$95.50
Median
$95.50
Typical High
$100.00
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$57.54
Median
$95.50
Typical High
$125.89
United
Setting
Professional
Modifier
None
Typical Low
$69.18
Median
$102.33
Typical High
$102.33
University Health Alliance
Setting
Professional
Modifier
None
Typical Low
$66.07
Median
$66.07
Typical High
$66.07

Where Hawaii sits

The same service costs 3.2 times more in Hawaii than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Hawaii· 1st of 51

$95.50

HI $95.50UT $30.20

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.