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New Jersey 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 $38 · 10th–90th $33–$580%20%40%10th90th$38Professionalmedian $42 · 10th–90th $29–$810%10%10th90th$42$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.11 / $33.11 / $40.74
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $38.02 / $53.70
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
$41.69 / $41.69 / $57.54
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $60.26 / $83.18
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $81.28 / $81.28
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.88 / $47.86 / $85.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $48.98 / $75.86