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Lumbar-Sacral Orthosis (LSO), Sagittal Control

New York 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?

$112

Typical negotiated rate. In New York, July 2026.

Insurers have agreed to pay about $112 for this service. The price depends on where it is billed: about $112 from a physician practice, and about $112 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 9 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$112$83.18 to $126
FacilityA hospital or hospital-owned outpatient department$112$87.10 to $145

How much rates vary

Facilitymedian $112 · 10th to 90th $68 to $195Professionalmedian $112 · 10th to 90th $66 to $204
$100$1K$10Kfacility $112professional $112

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
$66.07
Median
$83.18
Typical High
$147.91
Aetna
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$81.28
Typical High
$112.20
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$109.65
Typical High
$218.78
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$112.20
Typical High
$281.84
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$138.04
Typical High
$138.04
CDPHP
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$138.04
Cigna
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$128.82
Typical High
$169.82
Cigna
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$138.04
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$181.97
Typical High
$426.58
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$114.82
Typical High
$208.93
Excellus BCBS
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$112.20
Typical High
$117.49
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$120.23
Typical High
$128.82
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$245.47
Median
$50,118.72
Typical High
$75,857.76
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$104.71
Typical High
$165.96
United
Setting
Facility
Modifier
Global
Typical Low
$72.44
Median
$102.33
Typical High
$251.19
United
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$104.71
Typical High
$181.97
Univera
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$120.23
Typical High
$134.90
Univera
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$120.23
Typical High
$128.82

Where New York 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 York· 8th of 51

$112

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.