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Michigan 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 $282 · 10th–90th $129–$7410%20%10th90th$282Professionalmedian $145 · 10th–90th $100–$2340%20%10th90th$145$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
$128.82 / $128.82 / $128.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $128.82 / $194.98
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $549.54 / $1,071.52
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $186.21 / $194.98
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $141.25 / $141.25
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 / $213.80 / $380.19
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $616.60 / $691.83
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $234.42 / $316.23
Priority Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $213.80
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $288.40 / $346.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $181.97 / $346.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $162.18 / $269.15