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

Maine 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 $372 · 10th–90th $257$4270%20%40%10th90th$372Professionalmedian $269 · 10th–90th $170$2950%20%10th90th$269$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$218.78
Typical High
$295.12
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$371.54
Typical High
$426.58
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$281.84
Typical High
$281.84
Cigna
Setting
Facility
Modifier
Global
Typical Low
$302.00
Median
$302.00
Typical High
$302.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$218.78
Typical High
$302.00
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$269.15
Typical High
$323.59
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$281.84
Typical High
$302.00
United
Setting
Facility
Modifier
Global
Typical Low
$141.25
Median
$218.78
Typical High
$281.84
United
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$269.15
Typical High
$398.11