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Oklahoma 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 $45 · 10th–90th $35–$1170%20%10th90th$45Professionalmedian $42 · 10th–90th $30–$660%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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $34.67 / $34.67
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $36.31 / $53.70
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $66.07 / $66.07
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 / $72.44
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.88 / $60.26 / $275.42
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $48.98 / $97.72
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$43.65 / $51.29 / $85.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $44.67 / $64.57