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Idaho 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 $102 · 10th–90th $55–$1780%10%20%10th90th$102Professionalmedian $93 · 10th–90th $56–$1780%10%10th90th$93$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $87.10 / $109.65
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $154.88 / $199.53
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $177.83 / $177.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $128.82 / $134.90
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $93.33 / $128.82
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.90 / $93.33 / $144.54
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $77.62 / $97.72
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $134.90
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $117.49
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $112.20
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
$87.10 / $95.50 / $109.65
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $87.10 / $138.04