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

Wyoming 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 $219 · 10th–90th $200$2450%50%10th90th$219Professionalmedian $200 · 10th–90th $93$2570%20%10th90th$200$100.0$200.0$500.0

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
$93.33
Median
$114.82
Typical High
$257.04
BCBS
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$199.53
Typical High
$199.53
BCBS
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$199.53
Typical High
$199.53
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
United
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$218.78
Typical High
$245.47
United
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$218.78
Typical High
$371.54