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LSO, Flexible, Off-the-Shelf

New Hampshire 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 New Hampshire, October 2026.

Insurers have agreed to pay about $54.95 for this service. The price depends on where it is billed: about $54.95 from a physician practice, and about $64.57 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 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$54.95$48.98 to $54.95
FacilityA hospital or hospital-owned outpatient department$64.57$63.10 to $70.79

How much rates vary

Facilitymedian $65 · 10th to 90th $58 to $79Professionalmedian $55 · 10th to 90th $42 to $71
$50$100facility $65professional $55

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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
$54.95
Typical High
$54.95
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$58.88
Median
$69.18
Typical High
$81.28
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$54.95
Median
$54.95
Typical High
$54.95
Anthem BCBS
Setting
Professional
Modifier
RR · Rental
Typical Low
$5.50
Median
$5.50
Typical High
$5.50
Anthem BCBS
Setting
Professional
Modifier
UE · Used equipment
Typical Low
$40.74
Median
$40.74
Typical High
$40.74
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
$33.88
Median
$54.95
Typical High
$91.20
United
Setting
Professional
Modifier
None
Typical Low
$33.11
Median
$48.98
Typical High
$81.28
Well Sense
Setting
Facility
Modifier
None
Typical Low
$63.10
Median
$63.10
Typical High
$63.10

Where New Hampshire 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.

New Hampshire· 21st 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.