go back

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

Oklahoma 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 $182 · 10th–90th $166$5130%20%40%10th90th$182Professionalmedian $240 · 10th–90th $166$3470%20%10th90th$240$100.0$200.0$500.0$1.0K$2.0K

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
$165.96
Median
$173.78
Typical High
$173.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$173.78
Typical High
$275.42
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$537.03
Median
$537.03
Typical High
$537.03
BCBS
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$323.59
Typical High
$338.84
Cigna
Setting
Facility
Modifier
Global
Typical Low
$302.00
Median
$302.00
Typical High
$302.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$218.78
Typical High
$354.81
Medica
Setting
Facility
Modifier
Global
Typical Low
$158.49
Median
$218.78
Typical High
$1,174.90
Medica
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$239.88
Typical High
$478.63
United
Setting
Facility
Modifier
Global
Typical Low
$218.78
Median
$302.00
Typical High
$416.87
United
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$218.78
Typical High
$346.74