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Missouri 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 $1,622 · 10th–90th $912–$3,4670%20%10th90th$1,622Professionalmedian $977 · 10th–90th $724–$1,6980%20%10th90th$977$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
$1,047.13 / $1,047.13 / $1,202.26
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $977.24 / $1,698.24
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,041.74 / $7,079.46
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $977.24 / $1,862.09
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,202.26 / $2,041.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,023.29 / $1,071.52
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $1,023.29
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $1,584.89 / $8,511.38
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $1,000.00 / $10,964.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $1,621.81 / $1,621.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $912.01 / $1,445.44