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North Dakota 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 $1,175 · 10th–90th $1,096–$2,3990%20%40%10th90th$1,175Professionalmedian $1,096 · 10th–90th $708–$1,8620%10%20%10th90th$1,096$500.0$1.0K$2.0K$5.0K

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 / $1,174.90 / $1,174.90
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $851.14 / $1,202.26
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,778.28 / $1,949.84
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
$1,122.02 / $1,862.09 / $2,290.87
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $1,348.96 / $7,413.10
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $707.95 / $1,621.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $2,290.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $977.24 / $1,862.09