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

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

Rates data updated July 2026.

Facilitymedian $331 · 10th–90th $219$1,3490%10%10th90th$331Professionalmedian $191 · 10th–90th $170$5890%20%10th90th$191$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
Setting
Facility
Modifier
Global
Typical Low
$229.09
Median
$229.09
Typical High
$229.09
Aetna
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$190.55
Typical High
$588.84
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$724.44
Typical High
$851.14
BCBS
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$295.12
Typical High
$295.12
Cigna
Setting
Facility
Modifier
Global
Typical Low
$302.00
Median
$302.00
Typical High
$457.09
Cigna
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$436.52
Typical High
$1,000.00
Medica
Setting
Facility
Modifier
Global
Typical Low
$229.09
Median
$398.11
Typical High
$1,348.96
Medica
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$245.47
Typical High
$446.68
Midlands
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$446.68
Typical High
$1,071.52
Midlands
Setting
Facility
Modifier
Global
Typical Low
$457.09
Median
$457.09
Typical High
$457.09
Midlands
Setting
Professional
Modifier
Global
Typical Low
$602.56
Median
$1,000.00
Typical High
$1,071.52
United
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$316.23
Typical High
$416.87
United
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$245.47
Typical High
$389.05