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Michigan 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 $1,072 · 10th–90th $562–$3,0900%10%10th90th$1,072Professionalmedian $661 · 10th–90th $407–$1,0230%20%10th90th$661$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
$562.34 / $562.34 / $562.34
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $562.34 / $912.01
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,230.27 / $1,230.27
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $2,290.87 / $4,365.16
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $794.33
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $588.84 / $588.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $954.99
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $812.83 / $1,412.54
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $2,630.27 / $2,951.21
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $891.25 / $1,348.96
Priority Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $954.99
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $954.99 / $1,412.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $741.31 / $1,445.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $741.31 / $1,230.27