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Michigan rates for HCPCS L0641

Lumbar orthosis (LO), sagittal control, with rigid posterior panel(s), posterior extends from L-1 to below L-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf

Facilitymedian $76 · 10th–90th $35–$2040%10%10th90th$76Professionalmedian $41 · 10th–90th $27–$630%10%20%10th90th$41$0.1$0.5$2.0$10.0$50.0$200.0

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
$34.67 / $34.67 / $34.67
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $34.67 / $54.95
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $151.36 / $288.40
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $50.12 / $52.48
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.02 / $38.02 / $38.02
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $52.48
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $52.48 / $93.33
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $158.49 / $177.83
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $60.26 / $81.28
Priority Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $52.48
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $58.88 / $93.33
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.11 / $48.98 / $93.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $43.65 / $74.13