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New York 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 $933 · 10th–90th $501–$2,0890%20%10th90th$933Professionalmedian $661 · 10th–90th $490–$1,6980%20%10th90th$661$1.0$10.0$100.0$1.0K$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
$389.05 / $933.25 / $1,318.26
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $588.84 / $831.76
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,174.90 / $2,344.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $1,949.84
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $954.99 / $954.99
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $954.99 / $954.99
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $1,412.54
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,949.84 / $4,466.84
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $1,174.90 / $2,238.72
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $776.25 / $812.83
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $724.44 / $776.25
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,122.02 / $1,122.02
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $616.60 / $3,235.94
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $758.58 / $1,949.84
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $691.83 / $812.83
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $724.44 / $776.25