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Virginia 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 $1,585 · 10th–90th $759–$1,9950%20%40%10th90th$1,585Professionalmedian $851 · 10th–90th $631–$1,4790%20%10th90th$851$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
$630.96 / $758.58 / $1,995.26
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $758.58 / $1,412.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,584.89 / $1,584.89 / $1,698.24
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $933.25 / $1,949.84
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $870.96 / $1,096.48
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $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 / $1,584.89 / $2,238.72
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $1,047.13 / $1,548.82
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $1,023.29 / $1,819.70
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $954.99 / $1,995.26
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $1,288.25 / $3,388.44
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,288.25 / $3,388.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $707.95 / $1,949.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $776.25 / $1,258.93