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LSO, Flexible, Off-the-Shelf

Michigan 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?

$53.70

Typical negotiated rate. In Michigan, October 2026.

Insurers have agreed to pay about $53.70 for this service. The price depends on where it is billed: about $53.70 from a physician practice, and about $100 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 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$53.70$44.67 to $72.44
FacilityA hospital or hospital-owned outpatient department$100$57.54 to $186

How much rates vary

Facilitymedian $100 · 10th to 90th $56 to $234Professionalmedian $54 · 10th to 90th $34 to $95
$50$100$200$500facility $100professional $54

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
$30.90
Median
$53.70
Typical High
$53.70
Aetna
Setting
Professional
Modifier
None
Typical Low
$30.90
Median
$30.90
Typical High
$53.70
BCBS Michigan
Setting
Facility
Modifier
None
Typical Low
$64.57
Median
$158.49
Typical High
$302.00
BCBS Michigan
Setting
Professional
Modifier
None
Typical Low
$51.29
Median
$53.70
Typical High
$53.70
BCBS Michigan
Setting
Professional
Modifier
RR · Rental
Typical Low
$53.70
Median
$53.70
Typical High
$53.70
CareSource
Setting
Facility
Modifier
None
Typical Low
$41.69
Median
$41.69
Typical High
$41.69
Cigna
Setting
Facility
Modifier
None
Typical Low
$57.54
Median
$57.54
Typical High
$57.54
Cigna
Setting
Professional
Modifier
None
Typical Low
$41.69
Median
$57.54
Typical High
$97.72
Health Alliance Plan
Setting
Facility
Modifier
None
Typical Low
$38.02
Median
$194.98
Typical High
$213.80
Health Alliance Plan
Setting
Professional
Modifier
None
Typical Low
$38.02
Median
$72.44
Typical High
$95.50
Priority Health
Setting
Facility
Modifier
None
Typical Low
$57.54
Median
$57.54
Typical High
$57.54
Priority Health
Setting
Professional
Modifier
None
Typical Low
$41.69
Median
$57.54
Typical High
$102.33
United
Setting
Facility
Modifier
None
Typical Low
$85.11
Median
$100.00
Typical High
$120.23
United
Setting
Professional
Modifier
None
Typical Low
$37.15
Median
$47.86
Typical High
$69.18

Where Michigan 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.

Michigan· 27th of 51

$53.70

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.