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LSO, Flexible, Off-the-Shelf

Louisiana 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 July 2026.

Facilitymedian $78 · 10th–90th $52$1820%20%10th90th$78Professionalmedian $54 · 10th–90th $34$630%20%40%10th90th$54$0.1$0.5$2.0$10.0$50.0$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
Setting
Facility
Modifier
Global
Typical Low
$58.88
Median
$58.88
Typical High
$58.88
Aetna
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$54.95
Typical High
$63.10
BCBS
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$151.36
Typical High
$208.93
BCBS
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$60.26
Typical High
$60.26
Christus
Setting
Facility
Modifier
Global
Typical Low
$39.81
Median
$39.81
Typical High
$39.81
Cigna
Setting
Facility
Modifier
Global
Typical Low
$57.54
Median
$57.54
Typical High
$57.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$41.69
Typical High
$72.44
United
Setting
Facility
Modifier
Global
Typical Low
$33.88
Median
$67.61
Typical High
$100.00
United
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$46.77
Typical High
$64.57