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Indiana 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 $776 · 10th–90th $479–$1,2590%50%10th90th$776Professionalmedian $617 · 10th–90th $468–$1,0230%20%10th90th$617$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $478.63
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $562.34 / $891.25
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,174.90 / $1,174.90
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $776.25 / $1,288.25
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $741.31 / $1,288.25
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $1,174.90 / $1,348.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$537.03 / $812.83 / $954.99
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $588.84 / $1,023.29
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $630.96 / $1,000.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $741.31 / $1,148.15