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Hawaii 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 $110 · 10th–90th $87–$1510%20%10th90th$110Professionalmedian $85 · 10th–90th $65–$1950%20%10th90th$85$20.0$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
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $81.28 / $97.72
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $128.82 / $151.36
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $169.82 / $229.09
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $194.98
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $186.21 / $213.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $89.13 / $109.65
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $144.54 / $199.53