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

Illinois 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 $219 · 10th–90th $166$1,0960%20%10th90th$219Professionalmedian $204 · 10th–90th $166$3310%20%40%10th90th$204$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
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$165.96
Typical High
$269.15
Aetna
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$181.97
Typical High
$295.12
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$346.74
Typical High
$346.74
BCBS
Setting
Facility
Modifier
Global
Typical Low
$323.59
Median
$436.52
Typical High
$3,162.28
BCBS
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$204.17
Typical High
$204.17
Cigna
Setting
Facility
Modifier
Global
Typical Low
$302.00
Median
$302.00
Typical High
$457.09
Cigna
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$218.78
Typical High
$354.81
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$501.19
Typical High
$645.65
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$346.74
Typical High
$346.74
Molina
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$223.87
Typical High
$323.59
United
Setting
Facility
Modifier
Global
Typical Low
$218.78
Median
$218.78
Typical High
$371.54
United
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$239.88
Typical High
$371.54