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Virginia 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 $1,096 · 10th–90th $537–$1,3800%20%40%10th90th$1,096Professionalmedian $646 · 10th–90th $479–$1,1220%20%10th90th$646$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
$436.52 / $537.03 / $1,380.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $562.34 / $1,122.02
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,096.48 / $1,174.90
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $1,380.38
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $602.56 / $758.58
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $707.95 / $707.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $524.81
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,096.48 / $1,548.82
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $724.44 / $1,071.52
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $724.44 / $1,348.96
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $707.95 / $1,380.38
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $891.25 / $2,344.23
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $891.25 / $2,344.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $537.03 / $1,479.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $537.03 / $891.25