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Missouri 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 $1,288 · 10th–90th $832–$3,2360%20%10th90th$1,288Professionalmedian $851 · 10th–90th $676–$1,4130%20%40%10th90th$851$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
$831.76 / $831.76 / $954.99
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $831.76 / $1,348.96
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $1,621.81 / $5,623.41
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $933.25 / $1,479.11
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $977.24 / $1,621.81
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,122.02 / $1,174.90
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $1,122.02
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $1,288.25 / $7,413.10
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $794.33 / $7,943.28
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $1,288.25 / $1,288.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $758.58 / $1,202.26