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

New Hampshire 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 $282$3890%50%10th90th$331Professionalmedian $269 · 10th–90th $209$3390%20%10th90th$269$200.0$500.0$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
$281.84
Median
$281.84
Typical High
$338.84
Aetna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$281.84
Typical High
$338.84
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$338.84
Typical High
$389.05
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$281.84
Typical High
$281.84
Cigna
Setting
Facility
Modifier
Global
Typical Low
$302.00
Median
$302.00
Typical High
$302.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$218.78
Typical High
$302.00
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$269.15
Typical High
$501.19
United
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$223.87
Typical High
$275.42
United
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$269.15
Typical High
$389.05
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$302.00
Median
$302.00
Typical High
$446.68