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Minnesota 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 $316 · 10th–90th $209–$1,5490%20%10th90th$316Professionalmedian $263 · 10th–90th $132–$2820%50%10th90th$263$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
$173.78 / $173.78 / $173.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $147.91 / $208.93
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $281.84 / $407.38
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $281.84 / $281.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $794.33 / $1,905.46
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $281.84 / $316.23
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $794.33 / $1,548.82
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $245.47 / $338.84
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $213.80 / $933.25
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $154.88 / $331.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.45 / $151.36 / $416.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $181.97 / $354.81