go back

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

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

Rates data updated July 2026.

Facilitymedian $363 · 10th–90th $219$9550%20%10th90th$363Professionalmedian $251 · 10th–90th $145$5890%10%20%10th90th$251$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
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$245.47
Typical High
$363.08
Aetna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$229.09
Typical High
$588.84
Cigna
Setting
Facility
Modifier
Global
Typical Low
$302.00
Median
$302.00
Typical High
$457.09
Cigna
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$407.38
Typical High
$467.74
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$489.78
Typical High
$616.60
Medica
Setting
Facility
Modifier
Global
Typical Low
$234.42
Median
$524.81
Typical High
$1,348.96
Medica
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$331.13
Typical High
$831.76
Midlands
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$489.78
Typical High
$1,071.52
Midlands
Setting
Facility
Modifier
Global
Typical Low
$457.09
Median
$457.09
Typical High
$457.09
Midlands
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$831.76
Typical High
$831.76
United
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$316.23
Typical High
$794.33
United
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$245.47
Typical High
$426.58
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$407.38
Typical High
$407.38