go back

New Jersey 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 $407 · 10th–90th $389–$1,1750%20%40%10th90th$407Professionalmedian $617 · 10th–90th $447–$1,1480%10%10th90th$617$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
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $389.05 / $389.05
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $549.54 / $831.76
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $1,174.90
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $707.95
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,122.02 / $1,584.89
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,148.15 / $1,148.15
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$407.38 / $602.56 / $1,258.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $616.60 / $1,122.02