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North Dakota 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 $1,380 · 10th–90th $1,122–$2,8180%20%40%10th90th$1,380Professionalmedian $1,288 · 10th–90th $776–$2,1380%10%10th90th$1,288$500.0$1.0K$2.0K$5.0K$10.0K

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 / $1,380.38 / $1,380.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $954.99 / $1,380.38
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $2,089.30 / $2,290.87
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
$1,023.29 / $1,905.46 / $2,344.23
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $1,412.54 / $8,511.38
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $794.33 / $1,862.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $2,630.27
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $1,000.00 / $1,905.46