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Lumbar-Sacral Orthosis (LSO), Sagittal Control

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

Rates data updated July 2026.

How much does Lumbar-Sacral Orthosis (LSO), Sagittal Control cost?

$186

Typical negotiated rate. In Hawaii, July 2026.

Insurers have agreed to pay about $186 for this service. Most negotiated rates run $87.10 to $186.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $110 · 10th to 90th $87 to $151Professionalmedian $186 · 10th to 90th $66 to $195
$100$200facility $110professional $186

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$66.07
Typical High
$67.61
Cigna
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$128.82
Typical High
$151.36
Cigna
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$169.82
Typical High
$229.09
HMSA
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$186.21
Typical High
$194.98
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$186.21
Typical High
$257.04
United
Setting
Facility
Modifier
Global
Typical Low
$87.10
Median
$89.13
Typical High
$109.65
United
Setting
Professional
Modifier
Global
Typical Low
$31.62
Median
$144.54
Typical High
$239.88

Where Hawaii sits

The same service costs 3.6 times more in Kansas than in Washington, DC. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Hawaii· 2nd of 51

$186

KS $195DC $53.70

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.