go back

New York 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 $200 · 10th–90th $145–$3890%20%10th90th$200Professionalmedian $195 · 10th–90th $112–$3470%20%10th90th$195$0.5$5.0$50.0$500.0$5.0K$50.0K

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
$120.23 / $263.03 / $269.15
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $144.54 / $204.17
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $194.98 / $389.05
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $194.98 / $501.19
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $245.47 / $245.47
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $245.47 / $245.47
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $154.88 / $309.03
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $323.59 / $758.58
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $199.53 / $371.54
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $208.93
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $213.80 / $229.09
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $186.21 / $269.15
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $177.83 / $537.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $186.21 / $316.23
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $213.80 / $239.88
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $213.80 / $229.09