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Alaska rates for HCPCS L0636

Lumbar-sacral orthosis (LSO), sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to T-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, anterior panel, pendulous abdomen design, custom fabricated

Facilitymedian $955 · 10th–90th $513–$2,3990%20%40%10th90th$955Professionalmedian $1,072 · 10th–90th $813–$3,4670%20%10th90th$1,072$100.0$200.0$500.0$1.0K$2.0K$5.0K$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
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,047.13 / $2,137.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,023.29 / $1,023.29
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $2,951.21
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $1,412.54 / $2,398.83
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $2,398.83 / $5,011.87
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,412.54 / $2,454.71 / $2,570.40
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $2,454.71 / $2,570.40
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $2,187.76
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $1,023.29 / $1,548.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $1,047.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $1,584.89 / $6,165.95