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Missouri 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 $219 · 10th–90th $129$5500%20%10th90th$219Professionalmedian $155 · 10th–90th $110$2690%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
$128.82 / $128.82 / $147.91
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $134.90 / $239.88
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $758.58
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $194.98 / $338.84
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $131.83 / $218.78
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $223.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $154.88 / $213.80
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $208.93 / $933.25
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $169.82 / $1,445.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $173.78 / $229.09
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $165.96 / $239.88