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

Vermont 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 $275 · 10th–90th $174$3020%20%40%10th90th$275Professionalmedian $245 · 10th–90th $219$3020%20%10th90th$245$100.0$200.0$500.0$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$245.47
Typical High
$281.84
BCBS
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$288.40
Typical High
$288.40
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
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$380.19
Typical High
$380.19
United
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$218.78
Typical High
$275.42
United
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$371.54
Typical High
$724.44