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New York 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 $347 · 10th–90th $209–$4900%20%10th90th$347Professionalmedian $275 · 10th–90th $162–$5620%20%10th90th$275$0.5$5.0$50.0$500.0$5.0K$50.0K

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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $389.05 / $426.58
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $218.78 / $512.86
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $281.84 / $562.34
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $281.84 / $724.44
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $354.81 / $354.81
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $354.81
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $398.11
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $457.09 / $1,071.52
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $288.40 / $537.03
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $302.00
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $309.03 / $323.59
Fidelis
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $190.55
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $309.03
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $263.03 / $389.05
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $257.04 / $776.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $263.03 / $467.74
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $309.03 / $346.74
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $309.03 / $323.59