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Texas 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 $275 · 10th–90th $141–$1,3800%20%10th90th$275Professionalmedian $195 · 10th–90th $162–$3470%20%40%10th90th$195$0.5$2.0$10.0$50.0$200.0$1.0K$5.0K

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
$162.18 / $169.82 / $169.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $190.55 / $346.74
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $295.12 / $309.03
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,388.44 / $4,168.69
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $194.98 / $194.98
Baylor Scott & White
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $234.42 / $275.42
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $302.00 / $302.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $302.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $302.00
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,380.38 / $1,380.38
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,089.30 / $2,089.30
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $288.40 / $616.60
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $186.21 / $346.74
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $295.12
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $302.00 / $616.60
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $302.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $239.88 / $416.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $275.42 / $346.74
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $302.00 / $302.00