go back

South Dakota 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 $257 · 10th–90th $195$4270%10%10th90th$257Professionalmedian $214 · 10th–90th $155$3090%10%20%10th90th$214$50.0$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$257.04
Median
$257.04
Typical High
$257.04
Aetna
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$177.83
Typical High
$194.98
Cigna
Setting
Facility
Modifier
Global
Typical Low
$213.80
Median
$213.80
Typical High
$316.23
Cigna
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$251.19
Typical High
$309.03
Medica
Setting
Facility
Modifier
Global
Typical Low
$194.98
Median
$295.12
Typical High
$524.81
Medica
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$234.42
Typical High
$1,445.44
Midlands
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$309.03
Typical High
$316.23
Midlands
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$316.23
Typical High
$316.23
Midlands
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$316.23
Typical High
$630.96
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$239.88
Typical High
$295.12
United
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$177.83
Typical High
$257.04
United
Setting
Professional
Modifier
Global
Typical Low
$37.15
Median
$218.78
Typical High
$281.84
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$281.84
Typical High
$281.84