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LSO, Flexible, Off-the-Shelf

Nevada 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 $16 · 10th–90th $16$480%50%90th$16Professionalmedian $34 · 10th–90th $16$790%10%10th90th$34$1.0$2.0$5.0$10.0$20.0$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
$16.22
Median
$16.22
Typical High
$36.31
Aetna
Setting
Professional
Modifier
Global
Typical Low
$16.22
Median
$27.54
Typical High
$120.23
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$28.84
Median
$28.84
Typical High
$30.20
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$54.95
Typical High
$54.95
Cigna
Setting
Facility
Modifier
Global
Typical Low
$47.86
Median
$57.54
Typical High
$77.62
Cigna
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$41.69
Typical High
$63.10
Hometown Health
Setting
Professional
Modifier
Global
Typical Low
$19.95
Median
$28.84
Typical High
$57.54
Select Health
Setting
Facility
Modifier
Global
Typical Low
$28.84
Median
$28.84
Typical High
$28.84
Select Health
Setting
Professional
Modifier
Global
Typical Low
$19.50
Median
$25.70
Typical High
$83.18
United
Setting
Facility
Modifier
Global
Typical Low
$33.88
Median
$44.67
Typical High
$56.23
United
Setting
Professional
Modifier
Global
Typical Low
$21.38
Median
$44.67
Typical High
$66.07