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

Georgia 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 $316 · 10th–90th $186$1,1750%10%20%10th90th$316Professionalmedian $282 · 10th–90th $170$4900%20%10th90th$282$0.5$2.0$10.0$50.0$200.0$1.0K$5.0K

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
$186.21
Median
$186.21
Typical High
$501.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$234.42
Typical High
$489.78
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$457.09
Typical High
$794.33
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$758.58
Typical High
$1,174.90
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$416.87
Typical High
$549.54
CareSource
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$309.03
Typical High
$309.03
CareSource
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$263.03
Typical High
$263.03
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
$426.58
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$316.23
Typical High
$602.56
United
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$218.78
Typical High
$316.23
United
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$251.19
Typical High
$389.05