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LO, Rigid Posterior Panel, Off-the-Shelf

South Dakota 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

Rates data updated July 2026.

Facilitymedian $69 · 10th–90th $52$1170%10%20%10th90th$69Professionalmedian $58 · 10th–90th $43$830%10%20%10th90th$58$10.0$20.0$50.0$100.0$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$69.18
Typical High
$69.18
Aetna
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$47.86
Typical High
$52.48
Cigna
Setting
Facility
Modifier
Global
Typical Low
$52.48
Median
$52.48
Typical High
$85.11
Cigna
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$67.61
Typical High
$83.18
Medica
Setting
Facility
Modifier
Global
Typical Low
$52.48
Median
$79.43
Typical High
$144.54
Medica
Setting
Professional
Modifier
Global
Typical Low
$38.02
Median
$63.10
Typical High
$389.05
Midlands
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$85.11
Typical High
$85.11
Midlands
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$85.11
Typical High
$85.11
Midlands
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$85.11
Typical High
$169.82
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$64.57
Typical High
$79.43
United
Setting
Facility
Modifier
Global
Typical Low
$46.77
Median
$48.98
Typical High
$69.18
United
Setting
Professional
Modifier
Global
Typical Low
$10.00
Median
$58.88
Typical High
$75.86
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$75.86
Typical High
$75.86