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New York 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 $1,318 · 10th–90th $741$3,0900%20%10th90th$1,318Professionalmedian $977 · 10th–90th $741$2,3440%20%10th90th$977$2.0$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
$575.44 / $1,380.38 / $1,949.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $870.96 / $1,258.93
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,737.80 / $3,467.37
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,000.00 / $2,570.40
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,412.54 / $1,412.54
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,412.54 / $1,412.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,023.29 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $1,905.46
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,884.03 / $6,606.93
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,737.80 / $3,311.31
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,047.13 / $1,096.48
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,047.13 / $1,096.48
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,238.72 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,659.59 / $1,659.59
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $933.25 / $4,897.79
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $1,122.02 / $2,884.03
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $1,023.29 / $1,096.48
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,047.13 / $1,096.48