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Louisiana 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 $166 · 10th–90th $102–$3550%20%10th90th$166Professionalmedian $83 · 10th–90th $58–$1230%20%10th90th$83$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
$112.20 / $112.20 / $151.36
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $81.28 / $123.03
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $288.40 / $407.38
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $117.49
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 / $128.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $131.83 / $194.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $93.33 / $138.04