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Minnesota 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 $1,862 · 10th–90th $1,349–$11,7490%20%40%10th90th$1,862Professionalmedian $1,585 · 10th–90th $794–$1,8620%50%10th90th$1,585$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
$1,096.48 / $1,096.48 / $1,096.48
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $912.01 / $1,096.48
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,584.89 / $2,041.74
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,584.89 / $1,584.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,715.35 / $6,025.60 / $14,125.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $2,089.30 / $2,344.23
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,786.30 / $5,888.44 / $11,748.98
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $1,862.09 / $2,511.89
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $1,584.89 / $7,413.10
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $707.95 / $1,737.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11.22 / $707.95 / $2,290.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $831.76 / $2,238.72