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

West 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 $195 · 10th–90th $195$4170%50%90th$195Professionalmedian $195 · 10th–90th $135$3240%10%20%10th90th$195$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
Facility
Modifier
Global
Typical Low
$194.98
Median
$194.98
Typical High
$194.98
Aetna
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$194.98
Typical High
$275.42
CareSource
Setting
Facility
Modifier
Global
Typical Low
$204.17
Median
$204.17
Typical High
$416.87
CareSource
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$218.78
Typical High
$371.54
Cigna
Setting
Facility
Modifier
Global
Typical Low
$302.00
Median
$436.52
Typical High
$436.52
Cigna
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$218.78
Typical High
$1,445.44
United
Setting
Facility
Modifier
Global
Typical Low
$208.93
Median
$218.78
Typical High
$416.87
United
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$263.03
Typical High
$436.52