go back

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

Tennessee 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 $316 · 10th–90th $195$1,3800%20%10th90th$316Professionalmedian $195 · 10th–90th $170$3390%20%40%10th90th$195$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
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$194.98
Typical High
$309.03
Aetna
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$186.21
Typical High
$338.84
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$309.03
Typical High
$562.34
BCBS
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$309.03
Typical High
$331.13
Cigna
Setting
Facility
Modifier
Global
Typical Low
$302.00
Median
$302.00
Typical High
$346.74
Cigna
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$218.78
Typical High
$302.00
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$1,380.38
Median
$1,380.38
Typical High
$1,380.38
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$2,089.30
Median
$2,089.30
Typical High
$2,089.30
United
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$245.47
Typical High
$346.74
United
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$239.88
Typical High
$331.13