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Iowa rates for HCPCS L0635

Lumbar-sacral orthosis (LSO), sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, 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, anterior panel, pendulous abdomen design, prefabricated, includes fitting and adjustment

Facilitymedian $1,202 · 10th–90th $617–$3,4670%10%20%10th90th$1,202Professionalmedian $661 · 10th–90th $479–$1,2020%20%10th90th$661$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

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
$758.58 / $758.58 / $831.76
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $630.96 / $1,122.02
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $1,348.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $1,380.38 / $1,737.80
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,096.48 / $1,202.26
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $1,445.44 / $5,754.40
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $741.31 / $1,995.26
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,380.38 / $1,621.81
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,348.96 / $1,348.96
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,995.26 / $1,995.26
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,584.89 / $2,630.27
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $1,230.27 / $2,884.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $602.56 / $1,148.15
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,174.90 / $1,174.90