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Virginia 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 $1,622 · 10th–90th $794–$2,0420%20%40%10th90th$1,622Professionalmedian $955 · 10th–90th $724–$1,6600%20%40%10th90th$955$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
$645.65 / $794.33 / $2,041.74
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $794.33 / $1,659.59
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $1,621.81 / $1,737.80
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $977.24 / $2,041.74
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $891.25 / $1,122.02
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$691.83 / $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 / $1,621.81 / $2,290.87
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,071.52 / $1,584.89
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $1,096.48 / $1,995.26
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,047.13 / $2,041.74
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $1,318.26 / $3,467.37
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,318.26 / $3,467.37
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$537.03 / $794.33 / $2,187.76
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $794.33 / $1,318.26