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Maine 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 $1,288 · 10th–90th $708–$1,4790%20%40%10th90th$1,288Professionalmedian $661 · 10th–90th $501–$1,0720%20%10th90th$661$500.0$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $630.96 / $1,698.24
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,318.26 / $1,479.11
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $851.14
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $707.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $707.95
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $954.99 / $1,148.15
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $660.69 / $724.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $537.03 / $537.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $954.99 / $1,023.29