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

Hawaii 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 $275 · 10th–90th $219$3800%20%10th90th$275Professionalmedian $468 · 10th–90th $170$4900%50%10th90th$468$100.0$200.0$500.0$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
$165.96
Median
$169.82
Typical High
$295.12
Cigna
Setting
Facility
Modifier
Global
Typical Low
$302.00
Median
$302.00
Typical High
$380.19
Cigna
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$426.58
Typical High
$588.84
HMSA
Setting
Professional
Modifier
Global
Typical Low
$467.74
Median
$467.74
Typical High
$489.78
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$467.74
Typical High
$660.69
United
Setting
Facility
Modifier
Global
Typical Low
$218.78
Median
$223.87
Typical High
$275.42
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$371.54
Typical High
$602.56