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Hawaii 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 $794 · 10th–90th $631$1,2300%20%10th90th$794Professionalmedian $1,445 · 10th–90th $501$1,5140%50%10th90th$1,445$200.0$500.0$1.0K$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$794.33
Typical High
$794.33
Cigna
Setting
Facility
Modifier
Global
Typical Low
$812.83
Median
$812.83
Typical High
$1,230.27
Cigna
Setting
Professional
Modifier
Global
Typical Low
$812.83
Median
$1,318.26
Typical High
$1,778.28
HMSA
Setting
Professional
Modifier
Global
Typical Low
$1,445.44
Median
$1,445.44
Typical High
$1,513.56
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$1,000.00
Median
$1,445.44
Typical High
$1,995.26
United
Setting
Facility
Modifier
Global
Typical Low
$630.96
Median
$645.65
Typical High
$794.33
United
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$1,047.13
Typical High
$1,949.84