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Virginia 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 $316 · 10th–90th $191–$4900%50%10th90th$316Professionalmedian $257 · 10th–90th $162–$4170%20%10th90th$257$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $239.88 / $398.11
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $239.88 / $338.84
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $338.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $281.84 / $588.84
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $302.00 / $302.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $302.00 / $302.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $302.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $331.13 / $524.81
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $263.03 / $457.09
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $302.00 / $398.11
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $380.19 / $645.65
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $380.19 / $645.65
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $223.87 / $489.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $239.88 / $398.11