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California rates for HCPCS L0637

Lumbar-sacral orthosis (LSO), sagittal-coronal control, with rigid anterior and posterior frame/panels, 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, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

Rates data updated July 2026.

Facilitymedian $724 · 10th–90th $575$3,3110%20%10th90th$724Professionalmedian $776 · 10th–90th $631$1,9500%20%40%10th90th$776$1.0$5.0$20.0$100.0$500.0$2.0K$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
Setting
Facility
Modifier
Global
Typical Low
$758.58
Median
$2,238.72
Typical High
$6,165.95
Aetna
Setting
Professional
Modifier
Global
Typical Low
$676.08
Median
$758.58
Typical High
$1,737.80
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$1,096.48
Typical High
$1,174.90
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$575.44
Median
$724.44
Typical High
$3,162.28
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$794.33
Typical High
$1,737.80
Blue Shield
Setting
Facility
Modifier
Global
Typical Low
$724.44
Median
$2,454.71
Typical High
$3,467.37
Blue Shield
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$1,348.96
Typical High
$3,715.35
Cigna
Setting
Facility
Modifier
Global
Typical Low
$912.01
Median
$912.01
Typical High
$912.01
Cigna
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$660.69
Typical High
$912.01
Contra Costa Health
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$912.01
Typical High
$1,737.80
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$1,318.26
Typical High
$2,238.72
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$6,918.31
Median
$6,918.31
Typical High
$6,918.31
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$7,413.10
Median
$9,549.93
Typical High
$9,549.93
Molina
Setting
Professional
Modifier
Global
Typical Low
$1,479.11
Median
$1,479.11
Typical High
$1,479.11
Optum
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$54.95
Typical High
$70.79
Providence
Setting
Facility
Modifier
Global
Typical Low
$426.58
Median
$1,380.38
Typical High
$1,819.70
Providence
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$660.69
Typical High
$1,288.25
Sutter Health Plus
Setting
Professional
Modifier
Global
Typical Low
$2,691.53
Median
$2,691.53
Typical High
$2,691.53
The Alliance
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$1,000.00
Typical High
$1,318.26
United
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$630.96
Typical High
$1,737.80
United
Setting
Professional
Modifier
Global
Typical Low
$588.84
Median
$741.31
Typical High
$1,548.82