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LSO, Flexible, Off-the-Shelf

Maine 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 Maine, October 2026.

Insurers have agreed to pay about $54.95 for this service. Most negotiated rates run $48.98 to $60.26.

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 $81 · 10th to 90th $63 to $155Professionalmedian $55 · 10th to 90th $42 to $65
$50$100facility $81professional $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
Professional
Modifier
None
Typical Low
$42.66
Median
$60.26
Typical High
$60.26
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$63.10
Median
$81.28
Typical High
$154.88
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$54.95
Median
$54.95
Typical High
$60.26
Anthem BCBS
Setting
Professional
Modifier
RR · Rental
Typical Low
$4.57
Median
$5.50
Typical High
$6.03
Anthem BCBS
Setting
Professional
Modifier
UE · Used equipment
Typical Low
$30.90
Median
$40.74
Typical High
$43.65
Cigna
Setting
Facility
Modifier
None
Typical Low
$57.54
Median
$57.54
Typical High
$64.57
Cigna
Setting
Professional
Modifier
None
Typical Low
$41.69
Median
$41.69
Typical High
$57.54
Harvard Pilgrim
Setting
Professional
Modifier
None
Typical Low
$37.15
Median
$54.95
Typical High
$112.20
Martin's Point
Setting
Professional
Modifier
None
Typical Low
$42.66
Median
$60.26
Typical High
$60.26
United
Setting
Professional
Modifier
None
Typical Low
$33.11
Median
$48.98
Typical High
$138.04

Where Maine 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.

Maine· 19th 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.