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New Hampshire rates for HCPCS L0634

Lumbar-sacral orthosis (LSO), sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to T-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, custom fabricated

Rates data updated October 2026.

How much rates vary

Professionalmedian $302 · 10th to 90th $302 to $347
professional $302

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
Aetna
Setting
Professional
Modifier
None
Typical Low
$346.74
Median
$346.74
Typical High
$346.74
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$302.00
Median
$302.00
Typical High
$302.00
Anthem BCBS
Setting
Professional
Modifier
RR · Rental
Typical Low
$30.20
Median
$30.20
Typical High
$30.20
Anthem BCBS
Setting
Professional
Modifier
UE · Used equipment
Typical Low
$223.87
Median
$223.87
Typical High
$223.87