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Nebraska 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 $389 · 10th–90th $209–$1,3490%10%10th90th$389Professionalmedian $295 · 10th–90th $145–$9120%10%10th90th$295$100.0$200.0$500.0$1.0K$2.0K

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
$229.09 / $229.09 / $229.09
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $295.12 / $912.01
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $724.44 / $851.14
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $295.12 / $295.12
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $457.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $436.52 / $831.76
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $398.11 / $1,348.96
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $245.47 / $446.68
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $1,071.52
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $457.09 / $457.09
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $1,000.00 / $1,071.52
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $263.03 / $416.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $245.47 / $389.05