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North Carolina 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 $1,413 · 10th–90th $676–$2,6920%10%20%10th90th$1,413Professionalmedian $1,000 · 10th–90th $676–$1,4130%20%10th90th$1,000$1.0$10.0$100.0$1.0K$10.0K$100.0K

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
$1,412.54 / $1,412.54 / $2,290.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $912.01 / $1,412.54
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,230.27 / $1,348.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,122.02 / $1,122.02
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $1,202.26
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $794.33 / $1,047.13
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $1,412.54 / $2,344.23
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $707.95 / $1,318.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $794.33 / $1,122.02
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,585.78 / $7,585.78 / $7,585.78
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8,128.31 / $8,128.31 / $11,748.98