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Texas 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 $62 · 10th–90th $33–$2820%10%20%10th90th$62Professionalmedian $40 · 10th–90th $33–$590%20%10th90th$40$0.1$1.0$10.0$100.0$1.0K

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
$33.11 / $33.88 / $35.48
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $38.02 / $56.23
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,388.44 / $4,168.69
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $51.29
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $61.66 / $79.43
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
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $281.84 / $281.84
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $426.58
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.84 / $61.66 / $125.89
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $37.15 / $61.66
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $66.07 / $75.86
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $33.11 / $229.09
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.84 / $61.66 / $125.89
Providence
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
$34.67 / $48.98 / $85.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $53.70 / $64.57
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $61.66 / $61.66