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Idaho 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 $1,549 · 10th–90th $851–$2,0420%20%10th90th$1,549Professionalmedian $1,096 · 10th–90th $741–$1,8200%10%10th90th$1,096$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $977.24 / $1,412.54
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,548.82 / $2,630.27
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,819.70 / $1,819.70
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,023.29 / $1,348.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $1,023.29
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $1,412.54 / $1,949.84
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,584.89 / $1,659.59
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $1,412.54
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,584.89 / $1,584.89
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,148.15 / $1,737.80
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,659.59 / $1,905.46
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $912.01 / $1,047.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $794.33 / $1,230.27