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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

Rates data updated July 2026.

Facilitymedian $200 · 10th–90th $120$3470%20%10th90th$200Professionalmedian $195 · 10th–90th $117$3550%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
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$147.91
Typical High
$263.03
Aetna
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$144.54
Typical High
$199.53
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$194.98
Median
$194.98
Typical High
$389.05
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$194.98
Typical High
$501.19
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$229.09
Median
$245.47
Typical High
$245.47
CDPHP
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$245.47
Typical High
$245.47
Cigna
Setting
Facility
Modifier
Global
Typical Low
$213.80
Median
$213.80
Typical High
$302.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$154.88
Typical High
$218.78
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$194.98
Median
$323.59
Typical High
$758.58
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$204.17
Typical High
$371.54
Excellus BCBS
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$199.53
Typical High
$208.93
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$213.80
Typical High
$229.09
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$426.58
Median
$50,118.72
Typical High
$75,857.76
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$186.21
Typical High
$295.12
United
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$181.97
Typical High
$446.68
United
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$186.21
Typical High
$331.13
Univera
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$213.80
Typical High
$239.88
Univera
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$213.80
Typical High
$229.09