go back

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 July 2026.

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

$61.66

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $61.66 for this service. The price depends on where it is billed: about $61.66 from a physician practice, and about $75.86 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$61.66$50.12 to $79.43
FacilityA hospital or hospital-owned outpatient department$75.86$57.54 to $95.50

How much rates vary

Facilitymedian $76 · 10th to 90th $56 to $126Professionalmedian $62 · 10th to 90th $46 to $89
$50$100$200facility $76professional $62

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. 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
Global
Typical Low
$74.13
Median
$74.13
Typical High
$74.13
Aetna
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$52.48
Typical High
$56.23
Cigna
Setting
Facility
Modifier
Global
Typical Low
$57.54
Median
$57.54
Typical High
$93.33
Cigna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$72.44
Typical High
$89.13
Medica
Setting
Facility
Modifier
Global
Typical Low
$56.23
Median
$85.11
Typical High
$154.88
Medica
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$64.57
Typical High
$416.87
Midlands
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$91.20
Typical High
$91.20
Midlands
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$93.33
Midlands
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$91.20
Typical High
$181.97
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$69.18
Typical High
$85.11
United
Setting
Facility
Modifier
Global
Typical Low
$50.12
Median
$52.48
Typical High
$75.86
United
Setting
Professional
Modifier
Global
Typical Low
$10.96
Median
$64.57
Typical High
$85.11
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$81.28
Typical High
$81.28

Where South Dakota sits

The same service costs 3.5 times more in Hawaii than in Washington, DC. 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

$61.66

HI $95.50DC $27.54

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.