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Idaho 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 $1,479 · 10th–90th $832–$1,9050%20%10th90th$1,479Professionalmedian $1,047 · 10th–90th $631–$1,7380%10%10th90th$1,047$50.0$100.0$200.0$500.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $933.25 / $1,348.96
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,479.11 / $2,511.89
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,737.80 / $1,737.80
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $1,122.02 / $1,174.90
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $1,122.02
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $1,513.56 / $1,737.80
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,412.54 / $1,584.89
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $1,348.96
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,513.56 / $1,513.56
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,096.48 / $1,659.59
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,584.89 / $1,621.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $812.83 / $933.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $707.95 / $1,071.52