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

South Dakota 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 October 2026.

How much does LO, Rigid Anterior and Posterior Panels, Off-the-Shelf cost?

$355

Typical negotiated rate. In South Dakota, October 2026.

Insurers have agreed to pay about $355 for this service. The price depends on where it is billed: about $355 from a physician practice, and about $468 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$355$275 to $417
FacilityA hospital or hospital-owned outpatient department$468$347 to $468

How much rates vary

Facilitymedian $468 · 10th to 90th $324 to $759Professionalmedian $355 · 10th to 90th $214 to $447
$100$200$500$1K$2Kfacility $468professional $355

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$363.08
Median
$363.08
Typical High
$363.08
Aetna
Setting
Professional
Modifier
None
Typical Low
$213.80
Median
$275.42
Typical High
$302.00
Cigna
Setting
Facility
Modifier
None
Typical Low
$302.00
Median
$302.00
Typical High
$457.09
Cigna
Setting
Professional
Modifier
None
Typical Low
$354.81
Median
$436.52
Typical High
$446.68
Medica
Setting
Facility
Modifier
None
Typical Low
$346.74
Median
$467.74
Typical High
$758.58
Medica
Setting
Professional
Modifier
None
Typical Low
$199.53
Median
$302.00
Typical High
$2,041.74
Midlands
Setting
Professional
Modifier
None
Typical Low
$446.68
Median
$446.68
Typical High
$457.09
Midlands
Setting
Professional
Modifier
None
Typical Low
$446.68
Median
$446.68
Typical High
$891.25
Sanford Health Plan
Setting
Professional
Modifier
None
Typical Low
$302.00
Median
$302.00
Typical High
$416.87
United
Setting
Professional
Modifier
None
Typical Low
$181.97
Median
$245.47
Typical High
$389.05
Wellmark
Setting
Professional
Modifier
None
Typical Low
$407.38
Median
$407.38
Typical High
$407.38

Where South Dakota sits

The same service costs 2.6 times more in Hawaii than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

South Dakota· 6th of 51

$355

HI $490UT $191

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.