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

Washington, DC 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 $135 · 10th–90th $135$5890%50%90th$135Professionalmedian $135 · 10th–90th $135$3020%50%90th$135$100.0$200.0$500.0

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
$134.90
Median
$134.90
Typical High
$134.90
Aetna
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$134.90
Typical High
$234.42
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$302.00
Typical High
$302.00
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
$323.59
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$239.88
Typical High
$691.83
United
Setting
Facility
Modifier
Global
Typical Low
$588.84
Median
$588.84
Typical High
$588.84
United
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$239.88
Typical High
$309.03