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Indiana 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 $1,622 · 10th–90th $794–$1,9950%20%40%10th90th$1,622Professionalmedian $813 · 10th–90th $708–$1,3800%20%40%10th90th$813$1.0$5.0$20.0$100.0$500.0$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
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $794.33
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $794.33 / $1,318.26
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $1,621.81 / $2,041.74
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $933.25 / $1,621.81
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,584.89 / $2,089.30 / $2,398.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,122.02 / $1,621.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $1,737.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $933.25 / $1,288.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $794.33 / $1,148.15