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Hawaii 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 $1,122 · 10th–90th $708–$1,2300%20%40%10th90th$1,122Professionalmedian $933 · 10th–90th $676–$1,5850%20%10th90th$933$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $812.83 / $1,096.48
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,122.02 / $1,230.27
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,445.44 / $1,949.84
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $1,584.89 / $1,659.59
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,584.89 / $1,819.70
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $891.25 / $912.01
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,071.52 / $1,698.24