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Illinois 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 $1,995 · 10th–90th $832–$8,9130%20%10th90th$1,995Professionalmedian $891 · 10th–90th $741–$1,6600%20%40%10th90th$891$2.0$10.0$50.0$200.0$1.0K$5.0K$20.0K

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 / $1,659.59
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $870.96 / $1,659.59
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,238.72 / $4,168.69 / $11,220.18
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,230.27 / $1,230.27
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,023.29 / $2,238.72
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $1,905.46
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,905.46 / $2,344.23
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,137.96 / $2,137.96
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $912.01 / $1,318.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $1,318.26 / $2,630.27
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $812.83 / $1,412.54