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Michigan 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 $2,138 · 10th–90th $933–$6,6070%10%20%10th90th$2,138Professionalmedian $933 · 10th–90th $724–$1,6220%20%10th90th$933$2.0$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
$933.25 / $933.25 / $933.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $912.01 / $1,258.93
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $4,897.79 / $9,332.54
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $1,621.81 / $1,698.24
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,230.27 / $1,230.27
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 / $1,023.29 / $1,995.26
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $3,090.30 / $3,467.37
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,318.26 / $1,995.26
Priority Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,023.29 / $1,023.29
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,096.48 / $1,778.28
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $1,318.26 / $2,187.76
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $776.25 / $1,202.26