go back

LO, Rigid Anterior and Posterior Panels, Off-the-Shelf

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

Rates data updated July 2026.

Facilitymedian $240 · 10th–90th $65$4680%10%20%10th90th$240Professionalmedian $219 · 10th–90th $117$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
Setting
Facility
Modifier
Global
Typical Low
$223.87
Median
$223.87
Typical High
$223.87
Aetna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$208.93
Typical High
$426.58
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$309.03
Typical High
$316.23
BCBS
Setting
Facility
Modifier
Global
Typical Low
$58.88
Median
$239.88
Typical High
$457.09
BCBS
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$223.87
Typical High
$446.68
Cigna
Setting
Facility
Modifier
Global
Typical Low
$302.00
Median
$302.00
Typical High
$302.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$218.78
Typical High
$302.00
Medica
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$165.96
Typical High
$933.25
Medica
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$218.78
Typical High
$2,041.74
United
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$239.88
Typical High
$302.00
United
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$218.78
Typical High
$346.74