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LO, Rigid Posterior Panel, Off-the-Shelf

Wisconsin 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 $51 · 10th–90th $50$1120%50%10th90th$51Professionalmedian $51 · 10th–90th $31$980%20%10th90th$51$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
Setting
Facility
Modifier
Global
Typical Low
$30.90
Median
$190.55
Typical High
$190.55
Aetna
Setting
Professional
Modifier
Global
Typical Low
$30.90
Median
$30.90
Typical High
$53.70
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$51.29
Median
$51.29
Typical High
$85.11
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$47.86
Typical High
$57.54
Cigna
Setting
Facility
Modifier
Global
Typical Low
$52.48
Median
$208.93
Typical High
$302.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$85.11
Typical High
$95.50
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$30.90
Median
$50.12
Typical High
$77.62
DeanCare
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$77.62
Typical High
$85.11
Medica
Setting
Facility
Modifier
Global
Typical Low
$30.90
Median
$56.23
Typical High
$257.04
Medica
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$48.98
Typical High
$107.15
Molina
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$54.95
Typical High
$70.79
Network Health
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$79.43
Typical High
$125.89
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$30.90
Median
$50.12
Typical High
$77.62
Prevea360
Setting
Professional
Modifier
Global
Typical Low
$25.70
Median
$25.70
Typical High
$50.12
Quartz
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$60.26
Typical High
$114.82
Quartz
Setting
Facility
Modifier
Global
Typical Low
$52.48
Median
$104.71
Typical High
$263.03
Quartz
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$93.33
Typical High
$389.05
United
Setting
Facility
Modifier
Global
Typical Low
$29.51
Median
$46.77
Typical High
$66.07
United
Setting
Professional
Modifier
Global
Typical Low
$34.67
Median
$64.57
Typical High
$97.72