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Idaho 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 $58 · 10th–90th $33–$1100%10%10th90th$58Professionalmedian $49 · 10th–90th $29–$910%20%10th90th$49$10.0$20.0$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
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $48.98 / $53.70
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$40.74 / $85.11 / $131.83
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $91.20 / $91.20
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $61.66
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $41.69 / $57.54
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.84 / $54.95 / $91.20
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $40.74 / $51.29
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $70.79
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$40.74 / $40.74 / $60.26
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $57.54
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $42.66 / $83.18
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$44.67 / $48.98 / $54.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $44.67 / $67.61