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LSO, Flexible, Off-the-Shelf

South Dakota 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?

$72.44

Typical negotiated rate. In South Dakota, October 2026.

Insurers have agreed to pay about $72.44 for this service. The price depends on where it is billed: about $72.44 from a physician practice, and about $95.50 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 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$72.44$56.23 to $85.11
FacilityA hospital or hospital-owned outpatient department$95.50$69.18 to $95.50

How much rates vary

Facilitymedian $95 · 10th to 90th $66 to $155Professionalmedian $72 · 10th to 90th $41 to $91
$10$20$50$100$200facility $95professional $72

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
Facility
Modifier
None
Typical Low
$74.13
Median
$74.13
Typical High
$74.13
Aetna
Setting
Professional
Modifier
None
Typical Low
$43.65
Median
$56.23
Typical High
$56.23
Cigna
Setting
Facility
Modifier
None
Typical Low
$57.54
Median
$57.54
Typical High
$93.33
Cigna
Setting
Professional
Modifier
None
Typical Low
$72.44
Median
$89.13
Typical High
$91.20
Medica
Setting
Facility
Modifier
None
Typical Low
$69.18
Median
$95.50
Typical High
$154.88
Medica
Setting
Professional
Modifier
None
Typical Low
$40.74
Median
$61.66
Typical High
$416.87
Midlands
Setting
Professional
Modifier
None
Typical Low
$91.20
Median
$91.20
Typical High
$93.33
Midlands
Setting
Professional
Modifier
None
Typical Low
$91.20
Median
$91.20
Typical High
$181.97
Sanford Health Plan
Setting
Professional
Modifier
None
Typical Low
$61.66
Median
$61.66
Typical High
$85.11
United
Setting
Professional
Modifier
None
Typical Low
$37.15
Median
$50.12
Typical High
$79.43
Wellmark
Setting
Professional
Modifier
None
Typical Low
$81.28
Median
$81.28
Typical High
$81.28

Where South Dakota 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.

South Dakota· 6th of 51

$72.44

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.