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Virginia 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 $224 · 10th–90th $138–$3390%20%40%10th90th$224Professionalmedian $178 · 10th–90th $115–$2950%20%40%10th90th$178$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
$93.33 / $165.96 / $275.42
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $165.96 / $234.42
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $223.87 / $234.42
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $194.98 / $407.38
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $213.80 / $213.80
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $213.80 / $213.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $154.88 / $154.88
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $229.09 / $363.08
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $186.21 / $323.59
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $208.93 / $275.42
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $263.03 / $446.68
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $263.03 / $446.68
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $154.88 / $346.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $169.82 / $275.42