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Nebraska 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 $151 · 10th–90th $81–$5370%10%10th90th$151Professionalmedian $89 · 10th–90th $54–$2340%10%20%10th90th$89$50.0$100.0$200.0$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
$89.13 / $89.13 / $89.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $89.13 / $234.42
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $114.82 / $117.49
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $128.82 / $177.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $173.78 / $331.13
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $158.49 / $537.03
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $97.72 / $151.36
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $173.78 / $426.58
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $177.83
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $398.11 / $426.58
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $102.33 / $165.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $97.72 / $151.36