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Michigan 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 $331 · 10th–90th $186–$1,0720%10%10th90th$331Professionalmedian $224 · 10th–90th $145–$3390%20%10th90th$224$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $199.53 / $338.84
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $407.38
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $794.33 / $1,513.56
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $263.03 / $275.42
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $204.17
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 / $302.00 / $489.78
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $288.40 / $316.23
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $213.80 / $371.54
Priority Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $302.00
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $323.59 / $489.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $257.04 / $489.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $234.42 / $389.05