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Iowa 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 $257 · 10th–90th $155–$7080%10%10th90th$257Professionalmedian $155 · 10th–90th $112–$2820%20%10th90th$155$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
$154.88 / $154.88 / $251.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $144.54 / $239.88
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $316.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $245.47 / $316.23
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $331.13 / $354.81
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $363.08 / $933.25
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $229.09 / $575.44
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $331.13 / $758.58
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $316.23
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $575.44
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $263.03 / $407.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $257.04 / $676.08
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $169.82 / $295.12
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $275.42 / $275.42