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South 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 $1,000 · 10th–90th $759–$2,0420%20%10th90th$1,000Professionalmedian $813 · 10th–90th $676–$1,4130%10%20%10th90th$813$50.0$100.0$200.0$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
$794.33 / $794.33 / $794.33
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $812.83 / $1,412.54
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $1,621.81 / $1,905.46
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,122.02 / $1,230.27
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $1,862.09
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $794.33
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $1,174.90 / $2,511.89
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $457.09
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $1,071.52
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$537.03 / $891.25 / $1,949.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $794.33 / $1,071.52