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Pennsylvania 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 $661–$2,5700%20%10th90th$1,862Professionalmedian $832 · 10th–90th $661–$1,5850%20%10th90th$832$1.0$10.0$100.0$1.0K$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
$660.69 / $2,570.40 / $2,570.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $831.76 / $1,380.38
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $1,584.89 / $1,584.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,023.29 / $1,621.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $1,023.29
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $2,290.87 / $3,311.31
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $1,621.81 / $1,621.81
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,148.15 / $1,621.81
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $660.69
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $831.76 / $1,122.02
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $2,398.83 / $3,388.44
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,148.15 / $1,513.56
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,148.15 / $1,548.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $2,187.76 / $2,511.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $794.33 / $1,737.80