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Alaska rates for HCPCS L0649

Lumbar-sacral orthosis (LSO), sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to T-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf

Facilitymedian $69 · 10th–90th $69–$3090%50%90th$69Professionalmedian $174 · 10th–90th $100–$3090%10%10th90th$174$100.0$200.0$500.0$1.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $165.96 / $234.42
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $213.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $154.88 / $354.81
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $97.72 / $309.03
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $309.03 / $489.78
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $309.03 / $331.13
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $309.03 / $331.13
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $69.18 / $302.00
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $213.80 / $251.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $162.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $257.04 / $416.87