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New Mexico 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 $1,047 · 10th–90th $513–$1,9500%10%10th90th$1,047Professionalmedian $851 · 10th–90th $724–$1,5490%20%10th90th$851$100.0$200.0$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
$794.33 / $794.33 / $794.33
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $851.14 / $1,230.27
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,288.25 / $1,548.82
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 / $758.58 / $1,995.26
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,621.81 / $2,454.71
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $1,174.90 / $1,949.84
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $1,698.24
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $891.25 / $2,187.76
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $794.33 / $1,202.26