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Connecticut 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 $91 · 10th–90th $91–$1290%50%90th$91Professionalmedian $83 · 10th–90th $62–$1290%10%10th90th$83$50.0$100.0$200.0

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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $91.20 / $91.20
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $81.28 / $117.49
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $125.89 / $151.36
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $112.20 / $158.49
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $128.82 / $134.90
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $93.33 / $93.33
ConnectiCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $109.65
ConnectiCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $89.13 / $173.78
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $89.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $87.10 / $114.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $95.50 / $144.54