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Utah 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 $617 · 10th–90th $347–$1,0720%20%40%10th90th$617Professionalmedian $776 · 10th–90th $347–$6,3100%10%20%10th90th$776$50.0$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $346.74
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $645.65 / $6,309.57
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
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $794.33 / $1,000.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,071.52 / $1,071.52
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $776.25 / $1,202.26
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,071.52 / $1,258.93
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $1,096.48 / $1,513.56
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $537.03 / $616.60
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $537.03 / $870.96