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Georgia rates for HCPCS L0638

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, custom fabricated

Facilitymedian $1,778 · 10th–90th $759–$6,0260%20%40%10th90th$1,778Professionalmedian $912 · 10th–90th $708–$1,5490%20%10th90th$912$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $1,778.28 / $20,892.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $812.83 / $1,412.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $3,890.45 / $6,025.60
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,318.26 / $1,995.26
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,348.96 / $1,348.96
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,348.96 / $1,348.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,122.02 / $1,122.02
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $1,949.84
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,621.81 / $2,884.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $707.95 / $1,318.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $758.58 / $1,548.82