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New York rates for HCPCS L0629

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

Facilitymedian $178 · 10th–90th $54–$2630%50%10th90th$178Professionalmedian $174 · 10th–90th $174–$2290%50%90th$174$50.0$200.0$1.0K$5.0K$20.0K

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
$173.78 / $173.78 / $173.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $173.78 / $173.78
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $398.11
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $263.03 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $190.55
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $177.83 / $177.83
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $186.21
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $177.83 / $177.83
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $50,118.72 / $75,857.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $251.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $123.03 / $177.83
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $177.83 / $213.80
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $53.70 / $177.83