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North Dakota 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 $74 · 10th–90th $50–$1450%20%10th90th$74Professionalmedian $56 · 10th–90th $35–$760%10%20%10th90th$56$10.0$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
$50.12 / $74.13 / $144.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $50.12 / $74.13
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $69.18 / $75.86
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $57.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $72.44 / $89.13
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $74.13 / $275.42
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $44.67 / $83.18
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$44.67 / $44.67 / $120.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $61.66 / $83.18