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New Jersey 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 $120 · 10th–90th $120$2140%50%90th$120Professionalmedian $155 · 10th–90th $93$2820%10%10th90th$155$100.0$200.0$500.0$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
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$120.23
Typical High
$120.23
Aetna
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$131.83
Typical High
$194.98
Cigna
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$213.80
Typical High
$213.80
Cigna
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$154.88
Typical High
$213.80
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$204.17
Typical High
$281.84
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$281.84
Typical High
$281.84
United
Setting
Facility
Modifier
Global
Typical Low
$131.83
Median
$194.98
Typical High
$281.84
United
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$169.82
Typical High
$263.03