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South Carolina 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 $54 · 10th–90th $36–$1070%10%20%10th90th$54Professionalmedian $42 · 10th–90th $33–$690%10%20%10th90th$42$10.0$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
$36.31 / $36.31 / $36.31
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $38.02 / $67.61
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $83.18 / $102.33
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $63.10
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $41.69 / $72.44
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $51.29 / $51.29
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $64.57 / $128.82
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $28.84 / $28.84
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $69.18
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.88 / $53.70 / $100.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $50.12 / $63.10