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

Delaware 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 $234 · 10th–90th $0$3020%20%40%10th90th$234Professionalmedian $178 · 10th–90th $145$3980%20%10th90th$178$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$169.82
Typical High
$524.81
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
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$245.47
Typical High
$288.40
United
Setting
Facility
Modifier
Global
Typical Low
$0.35
Median
$218.78
Typical High
$234.42
United
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$263.03
Typical High
$380.19