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Tennessee 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 $1,230 · 10th–90th $708–$7,5860%20%10th90th$1,230Professionalmedian $776 · 10th–90th $692–$1,4130%20%40%10th90th$776$1.0$5.0$20.0$100.0$500.0$2.0K$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
$724.44 / $794.33 / $1,258.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $758.58 / $1,348.96
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,230.27 / $1,258.93
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,122.02 / $1,288.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $1,122.02
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,585.78 / $7,585.78 / $7,585.78
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8,128.31 / $11,748.98 / $11,748.98
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $707.95 / $1,122.02
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $758.58 / $1,023.29