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Ohio 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 $1,738 · 10th–90th $871–$2,8840%20%10th90th$1,738Professionalmedian $871 · 10th–90th $724–$1,5140%20%40%10th90th$871$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
$870.96 / $1,548.82 / $1,548.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $870.96 / $1,122.02
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,737.80 / $3,548.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $1,000.00 / $2,187.76
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $1,621.81 / $2,290.87
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,698.24 / $2,570.40
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
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,023.29 / $1,023.29
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $1,023.29
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $316.23 / $446.68
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $1,995.26
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $1,862.09 / $3,467.37
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $1,318.26 / $2,187.76
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $794.33 / $1,230.27