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Ohio 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 $288 · 10th–90th $200–$7080%20%10th90th$288Professionalmedian $234 · 10th–90th $145–$3890%20%10th90th$234$0.5$2.0$10.0$50.0$200.0$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $239.88 / $741.31
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $190.55 / $295.12
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $416.87 / $436.52
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $288.40 / $575.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $288.40 / $467.74
Aultcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $346.74 / $346.74
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $263.03 / $371.54
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $281.84 / $416.87
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $316.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $302.00
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $302.00
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $316.23
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $416.87 / $588.84
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $489.78 / $489.78
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $457.09 / $831.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $223.87 / $489.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $234.42 / $346.74