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Kentucky 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 $52 · 10th–90th $38–$930%20%10th90th$52Professionalmedian $38 · 10th–90th $29–$580%20%10th90th$38$20.0$50.0$100.0$200.0

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
$38.02 / $38.02 / $38.90
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $38.02 / $53.70
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$58.88 / $64.57 / $69.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $29.51 / $54.95
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$47.86 / $85.11 / $112.20
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $79.43 / $102.33
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $93.33 / $93.33
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $61.66 / $281.84
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $70.79 / $91.20
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.88 / $44.67 / $56.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $46.77 / $64.57