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Oregon 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 $1,585 · 10th–90th $1,230–$1,8200%20%40%10th90th$1,585Professionalmedian $1,047 · 10th–90th $759–$1,8200%10%10th90th$1,047$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
$977.24 / $977.24 / $977.24
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $954.99 / $1,380.38
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 / $758.58
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $3,548.13 / $4,265.80
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $1,230.27 / $1,819.70
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,318.26 / $1,819.70
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,584.89 / $1,819.70
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,621.81 / $1,862.09
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $1,380.38 / $1,995.26
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $1,412.54 / $1,698.24
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $2,570.40 / $6,309.57
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $1,819.70 / $1,819.70
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $1,023.29 / $2,630.27
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $794.33 / $1,513.56