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, custom fabricated
Rates data updated October 2026.
How much does LSO, Flexible, Custom Fabricated cost?
$174
Typical negotiated rate. In Michigan, October 2026.
Insurers have agreed to pay about $174 for this service. The price depends on where it is billed: about $174 from a physician practice, and about $302 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 6 insurance carriers under federal price transparency rules.
Prices by location type
Billed by
Who charges it
Typical
Range
Physician practiceA doctor's office, clinic or independent provider
A doctor's office, clinic or independent provider
$174
$81.28 to $251
FacilityA hospital or hospital-owned outpatient department
A hospital or hospital-owned outpatient department
$302
$263 to $794
How much rates vary
Facilitymedian $302 · 10th to 90th $174 to $1,122Professionalmedian $174 · 10th to 90th $62 to $251
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
Facility/Professional
Modifier
Typical LowTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
MedianTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
Typical HighTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
Aetna
Setting
Facility
Modifier
None
Typical Low
$173.78
Median
$173.78
Typical High
$173.78
Facility
None
$173.78
$173.78
$173.78
Aetna
Setting
Professional
Modifier
None
Typical Low
$173.78
Median
$173.78
Typical High
$173.78
Professional
None
$173.78
$173.78
$173.78
BCBS Michigan
Setting
Facility
Modifier
None
Typical Low
$302.00
Median
$741.31
Typical High
$1,412.54
Facility
None
$302.00
$741.31
$1,412.54
BCBS Michigan
Setting
Professional
Modifier
None
Typical Low
$239.88
Median
$251.19
Typical High
$251.19
Professional
None
$239.88
$251.19
$251.19
Cigna
Setting
Facility
Modifier
None
Typical Low
$263.03
Median
$263.03
Typical High
$263.03
Facility
None
$263.03
$263.03
$263.03
Cigna
Setting
Professional
Modifier
None
Typical Low
$147.91
Median
$190.55
Typical High
$263.03
Professional
None
$147.91
$190.55
$263.03
Health Alliance Plan
Setting
Facility
Modifier
None
Typical Low
$154.88
Median
$173.78
Typical High
$181.97
Facility
None
$154.88
$173.78
$181.97
Health Alliance Plan
Setting
Professional
Modifier
None
Typical Low
$61.66
Median
$81.28
Typical High
$173.78
Professional
None
$61.66
$81.28
$173.78
Priority Health
Setting
Facility
Modifier
None
Typical Low
$263.03
Median
$263.03
Typical High
$263.03
Facility
None
$263.03
$263.03
$263.03
Priority Health
Setting
Professional
Modifier
None
Typical Low
$147.91
Median
$190.55
Typical High
$263.03
Professional
None
$147.91
$190.55
$263.03
United
Setting
Professional
Modifier
None
Typical Low
$616.60
Median
$616.60
Typical High
$616.60
Professional
None
$616.60
$616.60
$616.60
1 more rate with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
Insurance Carrier
Facility/Professional
Modifier
Typical LowTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
MedianTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
Typical HighTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
BCBS Michigan
Setting
Professional
Modifier
RR · Rental
Typical Low
$251.19
Median
$251.19
Typical High
$251.19
Professional
RR · Rental
$251.19
$251.19
$251.19
Where Michigan sits
The same service costs 32.4 times more in South Dakota than in Hawaii. 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.