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Iowa 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 $363 · 10th–90th $224–$1,0230%20%10th90th$363Professionalmedian $234 · 10th–90th $162–$6030%20%10th90th$234$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $223.87 / $363.08
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $223.87 / $602.56
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $457.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $371.54 / $467.74
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $489.78 / $616.60
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $524.81 / $1,348.96
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $331.13 / $831.76
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $478.63 / $1,071.52
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $457.09 / $457.09
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $831.76 / $831.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $371.54 / $954.99
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $245.47 / $426.58
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $398.11 / $398.11