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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

Facilitymedian $16 · 10th–90th $16–$580%50%90th$16Professionalmedian $42 · 10th–90th $23–$650%10%20%10th90th$42$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.85 / $15.85 / $15.85
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $40.74 / $56.23
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.84 / $28.84 / $30.20
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $54.95 / $54.95
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$47.86 / $57.54 / $77.62
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $41.69 / $61.66
Hometown Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $28.84 / $56.23
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $41.69 / $83.18
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.88 / $44.67 / $52.48
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.38 / $44.67 / $66.07