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New York 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 $1,259 · 10th–90th $676–$2,8180%10%20%10th90th$1,259Professionalmedian $933 · 10th–90th $676–$2,1380%20%40%10th90th$933$1.0$10.0$100.0$1.0K$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
$524.81 / $1,258.93 / $1,778.28
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $776.25 / $1,096.48
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,584.89 / $1,584.89 / $3,162.28
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $954.99 / $2,454.71
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,288.25 / $1,288.25
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,288.25 / $1,288.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,122.02 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $1,862.09
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,584.89 / $2,630.27 / $6,025.60
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,584.89 / $3,019.95
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,047.13 / $1,096.48
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,000.00 / $1,047.13
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,238.72 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,513.56 / $1,513.56
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $831.76 / $4,365.16
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $1,023.29 / $2,570.40
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $1,047.13 / $1,122.02
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,000.00 / $1,047.13