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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

Rates data updated July 2026.

Facilitymedian $191 · 10th–90th $151$2690%20%10th90th$191Professionalmedian $331 · 10th–90th $117$3470%50%10th90th$331$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
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$117.49
Typical High
$120.23
Cigna
Setting
Facility
Modifier
Global
Typical Low
$213.80
Median
$213.80
Typical High
$269.15
Cigna
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$302.00
Typical High
$407.38
HMSA
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$331.13
Typical High
$346.74
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$331.13
Typical High
$457.09
United
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$158.49
Typical High
$190.55
United
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$257.04
Typical High
$416.87