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LSO, Flexible, Off-the-Shelf

Utah 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?

$30.20

Typical negotiated rate. In Utah, October 2026.

Insurers have agreed to pay about $30.20 for this service. The price depends on where it is billed: about $30.20 from a physician practice, and about $41.69 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$30.20$28.84 to $44.67
FacilityA hospital or hospital-owned outpatient department$41.69$28.84 to $57.54

How much rates vary

Facilitymedian $42 · 10th to 90th $29 to $58Professionalmedian $30 · 10th to 90th $23 to $60
$10$20$50$100facility $42professional $30

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
$28.84
Median
$28.84
Typical High
$28.84
Aetna
Setting
Professional
Modifier
None
Typical Low
$28.84
Median
$28.84
Typical High
$28.84
Cigna
Setting
Facility
Modifier
None
Typical Low
$57.54
Median
$57.54
Typical High
$64.57
Cigna
Setting
Professional
Modifier
None
Typical Low
$41.69
Median
$41.69
Typical High
$57.54
Molina
Setting
Professional
Modifier
None
Typical Low
$22.91
Median
$22.91
Typical High
$60.26
Regence BlueShield
Setting
Facility
Modifier
None
Typical Low
$40.74
Median
$41.69
Typical High
$93.33
Regence BlueShield
Setting
Professional
Modifier
None
Typical Low
$30.20
Median
$30.20
Typical High
$31.62
Select Health
Setting
Facility
Modifier
None
Typical Low
$42.66
Median
$42.66
Typical High
$42.66
Select Health
Setting
Professional
Modifier
None
Typical Low
$21.38
Median
$81.28
Typical High
$85.11
U of Utah Health Plan
Setting
Professional
Modifier
None
Typical Low
$32.36
Median
$47.86
Typical High
$77.62
United
Setting
Professional
Modifier
None
Typical Low
$16.22
Median
$43.65
Typical High
$44.67

Where Utah 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.

Utah· 51st of 51

$30.20

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.