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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

Facilitymedian $347 · 10th–90th $120–$9120%20%10th90th$347Professionalmedian $347 · 10th–90th $302–$4570%50%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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $346.74
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $346.74
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $588.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $50,118.72 / $53,703.18
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $776.25 / $776.25
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $776.25 / $812.83
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $933.25 / $933.25
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $50,118.72 / $75,857.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $281.84 / $281.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $562.34 / $776.25
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $776.25 / $912.01
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $776.25 / $933.25