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Oregon 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 $42 · 10th–90th $28–$810%20%10th90th$42Professionalmedian $42 · 10th–90th $28–$760%10%10th90th$42$10.0$50.0$200.0$1.0K$5.0K

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
$28.84 / $28.84 / $28.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $40.74 / $67.61
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 / $41.69
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.38 / $61.66 / $74.13
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.84 / $74.13 / $89.13
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$27.54 / $70.79 / $79.43
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.18 / $41.69 / $79.43
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $28.18 / $83.18
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.84 / $43.65 / $107.15
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $41.69 / $79.43
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$40.74 / $100.00 / $165.96
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $31.62 / $43.65
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $50.12 / $120.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $44.67 / $69.18