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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

Facilitymedian $275 · 10th–90th $219–$7080%20%10th90th$275Professionalmedian $170 · 10th–90th $112–$4170%20%10th90th$170$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $194.98 / $416.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $162.18 / $416.87
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $281.84 / $707.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $194.98 / $288.40
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $512.86 / $794.33
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $302.00 / $416.87
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 / $213.80
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $208.93 / $251.19
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $257.04 / $457.09
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $977.24 / $977.24
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,445.44 / $1,445.44
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $204.17
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $117.49 / $275.42
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $154.88 / $213.80
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $630.96 / $630.96
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $213.80 / $363.08
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.70 / $151.36 / $346.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $165.96 / $281.84