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

Indiana 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 $269 · 10th–90th $162$4170%50%10th90th$269Professionalmedian $219 · 10th–90th $148$3890%20%10th90th$219$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
$162.18
Median
$162.18
Typical High
$162.18
Aetna
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$165.96
Typical High
$275.42
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$616.60
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$239.88
Median
$269.15
Typical High
$512.86
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$295.12
Typical High
$478.63
CareSource
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$407.38
Typical High
$467.74
Cigna
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$302.00
Typical High
$436.52
Cigna
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$218.78
Typical High
$389.05
United
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$218.78
Typical High
$338.84
United
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$245.47
Typical High
$363.08