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New Mexico 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 $155 · 10th–90th $69–$2950%10%10th90th$155Professionalmedian $126 · 10th–90th $81–$2400%20%10th90th$126$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $114.82 / $194.98
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $162.18 / $229.09
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 / $154.88 / $263.03
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $204.17 / $309.03
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $120.23 / $223.87
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $154.88 / $213.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $169.82 / $346.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $154.88 / $239.88