go back

Montana 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 $1,047 · 10th–90th $708–$1,4130%20%40%10th90th$1,047Professionalmedian $741 · 10th–90th $490–$1,3180%10%10th90th$741$100.0$200.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $660.69 / $1,096.48
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $1,122.02 / $1,122.02
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $1,122.02 / $1,122.02
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $1,047.13 / $2,041.74
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,047.13 / $2,041.74
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$537.03 / $1,000.00 / $1,479.11
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $851.14 / $1,174.90
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$537.03 / $616.60 / $676.08
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $537.03 / $831.76