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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 July 2026.

How much does LSO, Flexible, Off-the-Shelf cost?

$54.95

Typical negotiated rate. In New Hampshire, July 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 $66.07 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$54.95$54.95 to $54.95
FacilityA hospital or hospital-owned outpatient department$66.07$61.66 to $69.18

How much rates vary

Facilitymedian $66 · 10th to 90th $55 to $79Professionalmedian $55 · 10th to 90th $43 to $66
$50$100facility $66professional $55

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$54.95
Typical High
$66.07
Aetna
Setting
Professional
Modifier
Global
Typical Low
$29.51
Median
$54.95
Typical High
$66.07
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$81.28
Typical High
$81.28
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$69.18
Typical High
$79.43
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$54.95
Typical High
$54.95
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
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$54.95
Typical High
$102.33
United
Setting
Facility
Modifier
Global
Typical Low
$27.54
Median
$44.67
Typical High
$56.23
United
Setting
Professional
Modifier
Global
Typical Low
$33.11
Median
$54.95
Typical High
$79.43
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$61.66
Median
$61.66
Typical High
$104.71

Where New Hampshire sits

The same service costs 3.5 times more in Hawaii than in Washington, DC. 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· 13th of 51

$54.95

HI $95.50DC $27.54

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.