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

Maryland 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 $257 · 10th–90th $170$3020%20%10th90th$257Professionalmedian $195 · 10th–90th $135$3390%20%10th90th$195$100.0$200.0$500.0$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
Professional
Modifier
Global
Typical Low
$134.90
Median
$165.96
Typical High
$338.84
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$302.00
Typical High
$302.00
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
$218.78
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$281.84
Typical High
$446.68
United
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$223.87
Typical High
$281.84
United
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$251.19
Typical High
$380.19
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$269.15
Typical High
$269.15