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Arizona rates for HCPCS L0642

Lumbar orthosis (LO), sagittal control, with rigid anterior and posterior panels, 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, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf

Facilitymedian $234 · 10th–90th $63–$4680%10%10th90th$234Professionalmedian $219 · 10th–90th $158–$3720%20%10th90th$219$0.5$2.0$10.0$50.0$200.0$1.0K

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
$223.87 / $223.87 / $223.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $223.87 / $467.74
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $309.03
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $234.42 / $436.52
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $213.80 / $407.38
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $302.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $302.00
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $165.96 / $933.25
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $218.78 / $2,041.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $239.88 / $245.47
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $218.78 / $346.74