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Hawaii 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 $191 · 10th–90th $151–$2690%20%10th90th$191Professionalmedian $151 · 10th–90th $115–$3470%20%10th90th$151$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $144.54 / $173.78
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $269.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $302.00 / $407.38
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $331.13 / $346.74
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $331.13 / $380.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $158.49 / $190.55
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $257.04 / $354.81