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New Jersey 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 $170 · 10th–90th $170–$3020%50%90th$170Professionalmedian $209 · 10th–90th $141–$3980%10%10th90th$209$100.0$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $169.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $190.55 / $275.42
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $302.00 / $302.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $302.00
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $295.12 / $407.38
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $398.11 / $398.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $234.42 / $416.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $239.88 / $380.19