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

North Carolina 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 $339 · 10th–90th $174$6760%20%40%10th90th$339Professionalmedian $331 · 10th–90th $174$3980%20%40%10th90th$331$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
$338.84
Median
$338.84
Typical High
$338.84
Aetna
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$338.84
Typical High
$426.58
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$309.03
BCBS
Setting
Facility
Modifier
Global
Typical Low
$416.87
Median
$501.19
Typical High
$758.58
BCBS
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$309.03
Typical High
$338.84
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
$323.59
Medcost
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$338.84
Typical High
$501.19
United
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$316.23
Typical High
$316.23
United
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$245.47
Typical High
$363.08
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$1,380.38
Median
$1,380.38
Typical High
$1,380.38
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$2,089.30
Median
$2,089.30
Typical High
$2,089.30