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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

Rates data updated July 2026.

Facilitymedian $331 · 10th–90th $65$8710%10%10th90th$331Professionalmedian $646 · 10th–90th $331$1,0960%10%20%10th90th$646$1.0$5.0$20.0$100.0$500.0$2.0K

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
Professional
Modifier
Global
Typical Low
$338.84
Median
$676.08
Typical High
$1,148.15
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$891.25
Typical High
$977.24
BCBS
Setting
Facility
Modifier
Global
Typical Low
$58.88
Median
$239.88
Typical High
$457.09
BCBS
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$223.87
Typical High
$446.68
Cigna
Setting
Facility
Modifier
Global
Typical Low
$812.83
Median
$812.83
Typical High
$812.83
Cigna
Setting
Professional
Modifier
Global
Typical Low
$588.84
Median
$588.84
Typical High
$812.83
Medica
Setting
Facility
Modifier
Global
Typical Low
$288.40
Median
$489.78
Typical High
$2,691.53
Medica
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$630.96
Typical High
$6,456.54
United
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$691.83
Typical High
$870.96
United
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$630.96
Typical High
$1,000.00