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Massachusetts 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 $302 · 10th–90th $209–$1,3800%20%10th90th$302Professionalmedian $269 · 10th–90th $162–$4070%20%10th90th$269$0.5$5.0$50.0$500.0$5.0K$50.0K

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
$208.93 / $208.93 / $208.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $208.93 / $346.74
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $338.84 / $1,380.38
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $302.00 / $426.58
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $912.01 / $2,754.23
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $380.19 / $562.34
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $302.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $323.59
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $3,630.78 / $9,772.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $407.38
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $234.42 / $234.42
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $338.84 / $1,380.38
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $302.00 / $426.58
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $263.03 / $489.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $269.15 / $371.54