go back

New York 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 July 2026.

Facilitymedian $347 · 10th–90th $120$7760%50%10th90th$347Professionalmedian $347 · 10th–90th $302$4570%20%40%10th90th$347$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
Setting
Facility
Modifier
Global
Typical Low
$346.74
Median
$346.74
Typical High
$346.74
Aetna
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$346.74
Typical High
$346.74
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$302.00
Typical High
$588.84
Cigna
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$70.79
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$616.60
Median
$776.25
Typical High
$776.25
Excellus BCBS
Setting
Facility
Modifier
Global
Typical Low
$776.25
Median
$776.25
Typical High
$812.83
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$776.25
Median
$933.25
Typical High
$933.25
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$1,659.59
Median
$50,118.72
Typical High
$75,857.76
United
Setting
Facility
Modifier
Global
Typical Low
$281.84
Median
$281.84
Typical High
$281.84
United
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$380.19
Typical High
$776.25
Univera
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$776.25
Typical High
$912.01
Univera
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$776.25
Typical High
$933.25