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Washington, DC 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 $52 · 10th–90th $52–$2340%50%90th$52Professionalmedian $65 · 10th–90th $52–$1150%20%10th90th$65$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
$52.48 / $52.48 / $52.48
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $64.57 / $114.82
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $120.23 / $120.23
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
$72.44 / $93.33 / $275.42
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $234.42 / $234.42
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $95.50 / $123.03