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

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

Rates data updated July 2026.

Facilitymedian $316 · 10th–90th $219$4900%50%10th90th$316Professionalmedian $240 · 10th–90th $148$4170%20%10th90th$240$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
$134.90
Median
$239.88
Typical High
$239.88
Aetna
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$239.88
Typical High
$275.42
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$316.23
Typical High
$338.84
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$281.84
Typical High
$588.84
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$302.00
Typical High
$302.00
Cigna
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$302.00
Typical High
$302.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$218.78
Typical High
$218.78
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$331.13
Typical High
$524.81
Medcost
Setting
Facility
Modifier
Global
Typical Low
$134.90
Median
$263.03
Typical High
$457.09
Medcost
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$302.00
Typical High
$398.11
Sentara
Setting
Facility
Modifier
Global
Typical Low
$239.88
Median
$380.19
Typical High
$645.65
Sentara
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$380.19
Typical High
$645.65
United
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$223.87
Typical High
$489.78
United
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$239.88
Typical High
$389.05