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Wisconsin rates for HCPCS L0648

Lumbar-sacral orthosis (LSO), sagittal control, with rigid anterior and posterior panels, 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, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf

Facilitymedian $676 · 10th–90th $661–$1,2300%50%10th90th$676Professionalmedian $617 · 10th–90th $407–$1,0230%20%10th90th$617$1.0$5.0$20.0$100.0$500.0$2.0K

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
$407.38 / $407.38 / $407.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $416.87 / $831.76
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $676.08 / $1,122.02
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $630.96 / $758.58
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $2,754.23 / $3,801.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $1,096.48 / $1,258.93
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$407.38 / $660.69 / $1,023.29
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $1,023.29 / $1,122.02
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$407.38 / $741.31 / $3,388.44
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $645.65 / $1,412.54
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $131.83
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $1,071.52 / $1,659.59
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $794.33 / $1,548.82
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $1,348.96 / $3,388.44
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $1,096.48 / $5,128.61
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $616.60 / $1,023.29
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $616.60 / $977.24