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Colorado rates for HCPCS L0643

Lumbar-sacral orthosis (LSO), sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to T-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf

Facilitymedian $78 · 10th–90th $45–$1290%20%10th90th$78Professionalmedian $81 · 10th–90th $46–$1150%20%10th90th$81$0.2$1.0$5.0$20.0$100.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$44.67 / $77.62 / $77.62
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $75.86 / $109.65
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $93.33 / $177.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $112.20 / $154.88
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $128.82 / $128.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $93.33 / $138.04
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $83.18 / $257.04
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $83.18 / $158.49
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $87.10 / $109.65
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $87.10 / $138.04