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LSO, Flexible, Off-the-Shelf

Tennessee 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?

$50.12

Typical negotiated rate. In Tennessee, October 2026.

Insurers have agreed to pay about $50.12 for this service. Most negotiated rates run $41.69 to $63.10.

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 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $58 · 10th to 90th $58 to $60Professionalmedian $50 · 10th to 90th $35 to $427
$50$100$200facility $58professional $50

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$36.31
Median
$36.31
Typical High
$36.31
Aetna
Setting
Professional
Modifier
None
Typical Low
$35.48
Median
$36.31
Typical High
$39.81
BCBS Tennessee
Setting
Professional
Modifier
None
Typical Low
$60.26
Median
$63.10
Typical High
$63.10
Cigna
Setting
Facility
Modifier
None
Typical Low
$57.54
Median
$57.54
Typical High
$60.26
Cigna
Setting
Professional
Modifier
None
Typical Low
$41.69
Median
$41.69
Typical High
$57.54
Lucent Health
Setting
Professional
Modifier
None
Typical Low
$426.58
Median
$426.58
Typical High
$426.58
United
Setting
Professional
Modifier
None
Typical Low
$30.20
Median
$47.86
Typical High
$57.54

Where Tennessee 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.

Tennessee· 31st of 51

$50.12

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.