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

Idaho 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 $263 · 10th–90th $141$4470%20%10th90th$263Professionalmedian $257 · 10th–90th $135$4470%20%10th90th$257$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
$128.82
Median
$302.00
Typical High
$302.00
Aetna
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$257.04
Typical High
$363.08
BCBS
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$389.05
Typical High
$501.19
BCBS
Setting
Professional
Modifier
Global
Typical Low
$426.58
Median
$446.68
Typical High
$446.68
Cigna
Setting
Facility
Modifier
Global
Typical Low
$302.00
Median
$302.00
Typical High
$316.23
Cigna
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$218.78
Typical High
$302.00
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$239.88
Typical High
$426.58
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$199.53
Typical High
$251.19
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$30.20
Typical High
$346.74
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$199.53
Typical High
$295.12
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$147.91
Typical High
$281.84
Select Health
Setting
Facility
Modifier
Global
Typical Low
$208.93
Median
$208.93
Typical High
$537.03
Select Health
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$275.42
Typical High
$407.38
United
Setting
Facility
Modifier
Global
Typical Low
$0.35
Median
$239.88
Typical High
$275.42
United
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$218.78
Typical High
$275.42