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LSO, Flexible, Off-the-Shelf

Rhode Island 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 October 2026.

How much does LSO, Flexible, Off-the-Shelf cost?

$54.95

Typical negotiated rate. In Rhode Island, October 2026.

Insurers have agreed to pay about $54.95 for this service. The price depends on where it is billed: about $54.95 from a physician practice, and about $145 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 4 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$54.95$46.77 to $58.88
FacilityA hospital or hospital-owned outpatient department$145$132 to $178

How much rates vary

Facilitymedian $145 · 10th to 90th $100 to $204Professionalmedian $55 · 10th to 90th $41 to $81
$50$100$200facility $145professional $55

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$47.86
Median
$58.88
Typical High
$58.88
BCBS Rhode Island
Setting
Facility
Modifier
None
Typical Low
$131.83
Median
$144.54
Typical High
$204.17
BCBS Rhode Island
Setting
Professional
Modifier
None
Typical Low
$38.90
Median
$54.95
Typical High
$70.79
Cigna
Setting
Facility
Modifier
None
Typical Low
$57.54
Median
$57.54
Typical High
$57.54
Cigna
Setting
Professional
Modifier
None
Typical Low
$41.69
Median
$41.69
Typical High
$57.54
United
Setting
Facility
Modifier
None
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
United
Setting
Professional
Modifier
None
Typical Low
$33.11
Median
$52.48
Typical High
$81.28

Where Rhode Island sits

The same service costs 3.2 times more in Hawaii than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Rhode Island· 17th of 51

$54.95

HI $95.50UT $30.20

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.