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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

Facilitymedian $219 · 10th–90th $166–$1,1220%20%10th90th$219Professionalmedian $200 · 10th–90th $162–$3720%20%10th90th$200$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $165.96 / $269.15
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $199.53 / $338.84
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $346.74
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $660.69 / $3,162.28
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $199.53 / $199.53
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
$218.78 / $218.78 / $354.81
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $501.19 / $645.65
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $346.74
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $223.87 / $323.59
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $218.78 / $588.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $239.88 / $371.54