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Nebraska 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 $1,862 · 10th–90th $794–$8,5110%10%10th90th$1,862Professionalmedian $1,259 · 10th–90th $661–$5,3700%10%10th90th$1,259$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
$1,258.93 / $1,258.93 / $1,258.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $1,258.93 / $9,332.54
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,905.46 / $1,949.84
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
$1,023.29 / $2,187.76 / $3,388.44
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,258.93 / $2,187.76 / $8,511.38
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $954.99 / $1,995.26
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,187.76 / $5,370.32
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,238.72 / $2,238.72 / $2,238.72
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,754.23 / $5,011.87 / $5,370.32
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $954.99 / $1,862.09
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $933.25 / $1,548.82