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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

Facilitymedian $138 · 10th–90th $55–$2040%20%10th90th$138Professionalmedian $43 · 10th–90th $34–$810%20%10th90th$43$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $42.66 / $151.36
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $144.54 / $204.17
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $54.95 / $85.11
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 / $57.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$44.67 / $54.95 / $100.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $52.48 / $79.43