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South Carolina 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 $1,122 · 10th–90th $832–$2,3990%20%10th90th$1,122Professionalmedian $933 · 10th–90th $759–$1,6600%10%20%10th90th$933$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
$933.25 / $933.25 / $933.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $933.25 / $1,659.59
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $1,905.46 / $2,238.72
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,023.29 / $1,148.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $1,905.46
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $812.83
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $1,258.93 / $3,090.30
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $512.86
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $1,288.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $1,000.00 / $2,187.76
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $933.25 / $1,202.26