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

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

Rates data updated July 2026.

Facilitymedian $170 · 10th–90th $170$3020%50%90th$170Professionalmedian $209 · 10th–90th $135$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$169.82
Typical High
$169.82
Aetna
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$190.55
Typical High
$275.42
Cigna
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$302.00
Typical High
$302.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$218.78
Typical High
$302.00
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$295.12
Typical High
$407.38
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$398.11
Typical High
$398.11
United
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$281.84
Typical High
$407.38
United
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$245.47
Typical High
$380.19