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LSO, Rigid Posterior Panel, Custom Fitted

Pennsylvania rates for HCPCS L0630

Lumbar-sacral orthosis (LSO), sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to T-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

Rates data updated July 2026.

How much does LSO, Rigid Posterior Panel, Custom Fitted cost?

$93.33

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $93.33 for this service. The price depends on where it is billed: about $93.33 from a physician practice, and about $302 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 9 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$93.33$81.28 to $120
FacilityA hospital or hospital-owned outpatient department$302$112 to $646

How much rates vary

Facilitymedian $302 · 10th to 90th $78 to $1,023Professionalmedian $93 · 10th to 90th $78 to $191
$1.0$10.0$100.0$1.0K$10.0Kfacility $302professional $93

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$77.62
Typical High
$302.00
Aetna
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$91.20
Typical High
$134.90
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$190.55
Cigna
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$112.20
Typical High
$269.15
Cigna
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$81.28
Typical High
$114.82
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$257.04
Typical High
$371.54
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$194.98
Median
$194.98
Typical High
$194.98
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$134.90
Typical High
$194.98
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$302.00
Typical High
$524.81
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$91.20
Typical High
$162.18
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$67.61
Typical High
$67.61
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$676.08
Typical High
$1,096.48
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$181.97
Typical High
$186.21
United
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$234.42
Typical High
$234.42
United
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$95.50
Typical High
$194.98

Where Pennsylvania sits

The same service costs 2.5 times more in Hawaii than in Washington, DC. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Pennsylvania $93.33 · 46th of 51
HI $195DC $77.62

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.