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California 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

Rates data updated July 2026.

Facilitymedian $275 · 10th–90th $219$7080%20%10th90th$275Professionalmedian $195 · 10th–90th $100$4170%20%10th90th$195$0.5$2.0$10.0$50.0$200.0$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
Setting
Facility
Modifier
Global
Typical Low
$194.98
Median
$194.98
Typical High
$416.87
Aetna
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$190.55
Typical High
$416.87
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$223.87
Median
$281.84
Typical High
$707.95
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$194.98
Typical High
$269.15
Blue Shield
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$549.54
Typical High
$831.76
Blue Shield
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$181.97
Typical High
$380.19
Cigna
Setting
Facility
Modifier
Global
Typical Low
$213.80
Median
$213.80
Typical High
$213.80
Cigna
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$154.88
Typical High
$213.80
Contra Costa Health
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$208.93
Typical High
$251.19
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$257.04
Typical High
$457.09
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$977.24
Median
$977.24
Typical High
$977.24
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$1,445.44
Median
$1,445.44
Typical High
$1,445.44
Molina
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$204.17
Typical High
$204.17
Providence
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$117.49
Typical High
$275.42
Providence
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$154.88
Typical High
$213.80
Sutter Health Plus
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$630.96
Typical High
$630.96
The Alliance
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$213.80
Typical High
$363.08
United
Setting
Facility
Modifier
Global
Typical Low
$25.70
Median
$151.36
Typical High
$346.74
United
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$162.18
Typical High
$281.84