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Missouri 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 $977 · 10th–90th $631–$2,6920%20%10th90th$977Professionalmedian $661 · 10th–90th $501–$1,1480%20%40%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
$630.96 / $630.96 / $724.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $630.96 / $1,096.48
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,230.27 / $4,265.80
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $660.69 / $1,148.15
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $741.31 / $1,230.27
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $741.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $707.95
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $977.24 / $5,754.40
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $602.56 / $8,709.64
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $977.24 / $977.24
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $575.44 / $954.99