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Arizona rates for HCPCS L0650

Lumbar-sacral orthosis (LSO), sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to T-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf

Facilitymedian $302 · 10th–90th $63–$8510%10%10th90th$302Professionalmedian $676 · 10th–90th $407–$1,6980%10%20%10th90th$676$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $707.95 / $1,737.80
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $977.24 / $977.24
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $234.42 / $436.52
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $213.80 / $426.58
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $812.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $588.84 / $812.83
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $489.78 / $2,691.53
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $630.96 / $6,456.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $691.83 / $691.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $630.96 / $1,000.00