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Washington 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 $54 · 10th–90th $25–$1450%10%20%10th90th$54Professionalmedian $38 · 10th–90th $22–$810%10%10th90th$38$1.0$5.0$20.0$100.0

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
$30.20 / $30.20 / $72.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $36.31 / $64.57
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.12 / $25.12 / $75.86
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $23.99 / $66.07
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 / $44.67 / $52.48
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.92 / $93.33 / $190.55
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $74.13 / $144.54
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $70.79 / $77.62
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.70 / $25.70 / $74.13
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$29.51 / $38.90 / $64.57
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.38 / $21.38 / $38.90
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.12 / $25.12 / $40.74
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $26.92 / $66.07
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21.38 / $112.20 / $112.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $41.69 / $69.18
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.62 / $22.91 / $66.07