LSO, Rigid Anterior and Posterior Panels, Custom Fitted
Tennessee rates for HCPCS L0631
Lumbar-sacral orthosis (LSO), sagittal control, with rigid anterior and posterior panels, 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, 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 October 2026.
How much does LSO, Rigid Anterior and Posterior Panels, Custom Fitted cost?
$617
Typical negotiated rate. In Tennessee, October 2026.
Insurers have agreed to pay about $617 for this service. Most negotiated rates run $550 to $955.
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.
How much rates vary
Facilitymedian $759 · 10th to 90th $759 to $794Professionalmedian $617 · 10th to 90th $550 to $6,310
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
$562.34
Median
$562.34
Typical High
$562.34
Facility
None
$562.34
$562.34
$562.34
Aetna
Setting
Professional
Modifier
None
Typical Low
$549.54
Median
$562.34
Typical High
$707.95
Professional
None
$549.54
$562.34
$707.95
BCBS Tennessee
Setting
Professional
Modifier
None
Typical Low
$741.31
Median
$954.99
Typical High
$954.99
Professional
None
$741.31
$954.99
$954.99
Cigna
Setting
Facility
Modifier
None
Typical Low
$758.58
Median
$758.58
Typical High
$794.33
Facility
None
$758.58
$758.58
$794.33
Cigna
Setting
Professional
Modifier
None
Typical Low
$549.54
Median
$549.54
Typical High
$758.58
Professional
None
$549.54
$549.54
$758.58
Lucent Health
Setting
Professional
Modifier
None
Typical Low
$6,309.57
Median
$9,332.54
Typical High
$9,332.54
Professional
None
$6,309.57
$9,332.54
$9,332.54
United
Setting
Professional
Modifier
None
Typical Low
$389.05
Median
$588.84
Typical High
$724.44
Professional
None
$389.05
$588.84
$724.44
2 more rates 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.
Ambetter
Setting
Professional
Modifier
KX · Policy requirements met
Typical Low
$346.74
Median
$346.74
Typical High
$346.74
Professional
KX · Policy requirements met
$346.74
$346.74
$346.74
Cigna
Setting
Professional
Modifier
RR · Rental
Typical Low
$75.86
Median
$75.86
Typical High
$75.86
Professional
RR · Rental
$75.86
$75.86
$75.86
Where Tennessee sits
The same service costs 2.2 times more in Iowa than in Delaware. 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.