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

Minnesota 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 $708 · 10th–90th $302$2,5120%10%20%10th90th$708Professionalmedian $380 · 10th–90th $245$4070%20%40%10th90th$380$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
$245.47
Median
$245.47
Typical High
$245.47
Aetna
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$245.47
Typical High
$363.08
BCBS
Setting
Facility
Modifier
Global
Typical Low
$363.08
Median
$407.38
Typical High
$616.60
BCBS
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$407.38
Typical High
$407.38
Cigna
Setting
Facility
Modifier
Global
Typical Low
$691.83
Median
$1,148.15
Typical High
$3,162.28
Cigna
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$398.11
Typical High
$446.68
Health Partners
Setting
Facility
Modifier
Global
Typical Low
$891.25
Median
$1,258.93
Typical High
$2,511.89
Health Partners
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$354.81
Typical High
$478.63
Medica
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$302.00
Typical High
$1,348.96
Medica
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$218.78
Typical High
$478.63
United
Setting
Facility
Modifier
Global
Typical Low
$3.55
Median
$218.78
Typical High
$588.84
United
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$257.04
Typical High
$501.19