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

Utah 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.

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

$219

Typical negotiated rate. In Utah, July 2026.

Insurers have agreed to pay about $219 for this service. The price depends on where it is billed: about $219 from a physician practice, and about $191 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$219$182 to $302
FacilityA hospital or hospital-owned outpatient department$191$191 to $204

How much rates vary

Facilitymedian $191 · 10th to 90th $191 to $269Professionalmedian $219 · 10th to 90th $105 to $589
$100$200$500facility $191professional $219

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$190.55
Aetna
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$275.42
Typical High
$588.84
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
$302.00
Molina
Setting
Professional
Modifier
Global
Typical Low
$34.67
Median
$112.20
Typical High
$407.38
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$204.17
Typical High
$269.15
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$147.91
Typical High
$281.84
Select Health
Setting
Facility
Modifier
Global
Typical Low
$208.93
Median
$208.93
Typical High
$208.93
Select Health
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$208.93
Typical High
$407.38
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$208.93
Typical High
$309.03
United
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$218.78
Typical High
$275.42
United
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$213.80
Typical High
$346.74

Where Utah sits

The same service costs 3.5 times more in Hawaii than in Washington, DC. 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.

Utah· 34th of 51

$219

HI $468DC $135

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.