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Texas 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 $1,288 · 10th–90th $692–$4,1690%10%10th90th$1,288Professionalmedian $759 · 10th–90th $676–$1,0720%50%10th90th$759$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
$707.95 / $707.95 / $741.31
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $758.58 / $1,047.13
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $758.58
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $1,621.81 / $1,621.81
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 / $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
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $1,380.38 / $2,137.96
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $758.58 / $1,584.89
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,071.52 / $1,096.48
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,025.60 / $6,025.60 / $6,025.60
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $1,258.93 / $2,238.72
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $1,122.02
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $1,023.29 / $1,659.59
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $851.14 / $1,023.29
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $1,621.81 / $1,621.81