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Ohio 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 $151–$3470%20%40%10th90th$200Professionalmedian $162 · 10th–90th $100–$2570%20%10th90th$162$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
$97.72 / $194.98 / $234.42
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $131.83 / $194.98
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $199.53 / $407.38
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $199.53 / $323.59
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $186.21 / $263.03
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $194.98 / $295.12
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
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $213.80
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $154.88 / $213.80
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $208.93 / $295.12
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $346.74
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $354.81 / $660.69
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $158.49 / $346.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $162.18 / $239.88