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Lumbar-Sacral Orthosis (LSO), Sagittal Control

New Hampshire 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?

$107

Typical negotiated rate. In New Hampshire, July 2026.

Insurers have agreed to pay about $107 for this service. The price depends on where it is billed: about $107 from a physician practice, and about $132 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$107$107 to $112
FacilityA hospital or hospital-owned outpatient department$132$126 to $135

How much rates vary

Facilitymedian $132 · 10th to 90th $112 to $155Professionalmedian $107 · 10th to 90th $83 to $135
$100$200facility $132professional $107

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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$112.20
Typical High
$134.90
Aetna
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$112.20
Typical High
$134.90
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$134.90
Typical High
$154.88
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$112.20
Typical High
$112.20
Cigna
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$128.82
Typical High
$128.82
Cigna
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$128.82
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$107.15
Typical High
$199.53
United
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$89.13
Typical High
$109.65
United
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$107.15
Typical High
$154.88
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$117.49
Typical High
$151.36

Where New Hampshire 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.

New Hampshire· 12th of 51

$107

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.