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South Carolina 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 $240 · 10th–90th $178–$4900%20%10th90th$240Professionalmedian $214 · 10th–90th $162–$3390%10%20%10th90th$214$50.0$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $177.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $194.98 / $338.84
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $416.87 / $512.86
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $331.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $354.81
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $251.19 / $588.84
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $141.25
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $338.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $263.03 / $489.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $245.47 / $354.81