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Missouri 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 $316 · 10th–90th $186–$7940%20%10th90th$316Professionalmedian $240 · 10th–90th $162–$5010%10%20%10th90th$240$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 / $213.80
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $208.93 / $512.86
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $1,096.48
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $295.12 / $489.78
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $316.23
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $316.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $302.00
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $295.12 / $1,348.96
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $245.47 / $2,041.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $251.19 / $331.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $234.42 / $346.74