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LSO, Flexible, Off-the-Shelf

Indiana 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?

$54.95

Typical negotiated rate. In Indiana, October 2026.

Insurers have agreed to pay about $54.95 for this service. The price depends on where it is billed: about $54.95 from a physician practice, and about $54.95 from a hospital or other facility.

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.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$54.95$44.67 to $58.88
FacilityA hospital or hospital-owned outpatient department$54.95$48.98 to $58.88

How much rates vary

Facilitymedian $55 · 10th to 90th $44 to $135Professionalmedian $55 · 10th to 90th $33 to $81
$50$100$200$500$1K$2Kfacility $55professional $55

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$33.11
Median
$33.11
Typical High
$33.11
Aetna
Setting
Professional
Modifier
None
Typical Low
$31.62
Median
$33.11
Typical High
$44.67
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$43.65
Median
$54.95
Typical High
$69.18
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$54.95
Median
$54.95
Typical High
$75.86
Anthem BCBS
Setting
Professional
Modifier
RR · Rental
Typical Low
$5.50
Median
$5.50
Typical High
$7.76
Anthem BCBS
Setting
Professional
Modifier
UE · Used equipment
Typical Low
$40.74
Median
$40.74
Typical High
$57.54
CareSource
Setting
Facility
Modifier
None
Typical Low
$91.20
Median
$91.20
Typical High
$95.50
Cigna
Setting
Facility
Modifier
None
Typical Low
$54.95
Median
$57.54
Typical High
$64.57
Cigna
Setting
Professional
Modifier
None
Typical Low
$41.69
Median
$57.54
Typical High
$295.12
Physicians Health Plan of Northern Indiana
Setting
Facility
Modifier
None
Typical Low
$83.18
Median
$173.78
Typical High
$2,187.76
Physicians Health Plan of Northern Indiana
Setting
Professional
Modifier
None
Typical Low
$35.48
Median
$51.29
Typical High
$83.18
United
Setting
Professional
Modifier
None
Typical Low
$30.20
Median
$50.12
Typical High
$74.13

Where Indiana 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.

Indiana· 23rd of 51

$54.95

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.