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Washington 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 $1,230 · 10th–90th $832–$2,8840%10%20%10th90th$1,230Professionalmedian $832 · 10th–90th $525–$1,7780%10%10th90th$832$10.0$50.0$200.0$1.0K$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
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $831.76 / $1,995.26
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $660.69 / $1,122.02
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,202.26 / $1,202.26
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,071.52 / $1,380.38
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
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $1,621.81 / $3,548.13
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,513.56 / $2,511.89
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $954.99 / $1,047.13
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $1,202.26 / $1,230.27
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,230.27 / $1,230.27
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,819.70 / $2,511.89
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,023.29 / $1,202.26
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,202.26 / $1,202.26
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,071.52 / $1,380.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$537.03 / $1,778.28 / $1,778.28
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $575.44 / $1,023.29
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,071.52 / $1,905.46