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Oregon 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 $54 · 10th–90th $54–$1550%50%90th$54Professionalmedian $79 · 10th–90th $52–$1450%10%10th90th$79$20.0$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
$56.23 / $56.23 / $56.23
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $77.62 / $131.83
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 / $93.33
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $117.49 / $144.54
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $144.54 / $144.54
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $77.62 / $151.36
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $151.36
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $64.57 / $165.96
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $85.11 / $151.36
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $190.55 / $316.23
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $61.66 / $85.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $95.50 / $234.42
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $87.10 / $138.04