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New Mexico 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 $219 · 10th–90th $100–$3160%10%10th90th$219Professionalmedian $182 · 10th–90th $117–$3470%20%10th90th$182$100.0$200.0$500.0

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
$181.97 / $181.97 / $181.97
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $162.18 / $275.42
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $234.42 / $331.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $302.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $371.54
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $346.74 / $524.81
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $162.18 / $302.00
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $218.78 / $302.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $239.88 / $489.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $218.78 / $346.74