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Minnesota 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 $1,905 · 10th–90th $1,413–$12,0230%20%10th90th$1,905Professionalmedian $1,622 · 10th–90th $832–$1,9050%50%10th90th$1,622$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
$1,122.02 / $1,122.02 / $1,122.02
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,047.13 / $1,258.93
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,584.89 / $1,621.81 / $2,137.96
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,621.81 / $1,621.81
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,801.89 / $6,165.95 / $14,791.08
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,137.96 / $2,398.83
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,897.79 / $6,025.60 / $12,022.64
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,905.46 / $2,570.40
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$691.83 / $1,621.81 / $8,511.38
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $794.33 / $1,949.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.59 / $794.33 / $2,630.27
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $933.25 / $2,290.87