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LSO, Flexible, Off-the-Shelf

Mississippi 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 $72 · 10th–90th $37$1000%20%40%10th90th$72Professionalmedian $47 · 10th–90th $34$600%20%10th90th$47$50.0$100.0

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
$37.15
Median
$37.15
Typical High
$57.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$44.67
Typical High
$60.26
BCBS
Setting
Facility
Modifier
Global
Typical Low
$72.44
Median
$72.44
Typical High
$72.44
BCBS
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$64.57
Typical High
$64.57
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
$57.54
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$30.20
Typical High
$52.48
United
Setting
Facility
Modifier
Global
Typical Low
$30.20
Median
$60.26
Typical High
$120.23
United
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$47.86
Typical High
$69.18