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Kansas 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 $39–$2040%20%10th90th$110Professionalmedian $129 · 10th–90th $63–$1950%20%40%10th90th$129$0.2$1.0$5.0$20.0$100.0$500.0

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
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $109.65
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $75.86 / $114.82
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $194.98 / $194.98
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 / $138.04
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.90 / $107.15 / $467.74
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $97.72 / $812.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $97.72 / $144.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $93.33 / $151.36