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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

Facilitymedian $316 · 10th–90th $186–$1,1750%10%20%10th90th$316Professionalmedian $275 · 10th–90th $166–$5370%20%10th90th$275$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $501.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $218.78 / $537.03
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $457.09 / $794.33
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $758.58 / $1,174.90
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $416.87 / $549.54
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $309.03
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $263.03 / $263.03
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 / $426.58
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $316.23 / $602.56
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $218.78 / $331.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $251.19 / $389.05