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Oregon 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 $1,514 · 10th–90th $1,175–$1,5850%20%40%10th90th$1,514Professionalmedian $933 · 10th–90th $676–$1,7380%20%10th90th$933$100.0$500.0$2.0K$10.0K$50.0K

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
$933.25 / $933.25 / $933.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $851.14 / $1,202.26
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 / $812.83
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $3,162.28 / $3,801.89
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $1,174.90 / $1,584.89
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,230.27 / $1,698.24
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,513.56 / $1,584.89
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,548.82 / $1,698.24
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $1,318.26 / $1,862.09
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $1,348.96 / $1,659.59
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $2,454.71 / $6,025.60
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,737.80 / $1,737.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $912.01 / $2,290.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $707.95 / $1,348.96