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Montana 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 $708 · 10th–90th $575–$1,7380%20%10th90th$708Professionalmedian $724 · 10th–90th $331–$1,5850%20%10th90th$724$100.0$500.0$2.0K$10.0K$50.0K

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
$331.13 / $794.33 / $1,584.89
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,479.11 / $69,183.10 / $95,499.26
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,047.13 / $1,047.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $1,122.02 / $1,122.02
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,122.02 / $1,122.02
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $676.08 / $1,621.81
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $676.08 / $1,621.81
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $891.25 / $1,258.93
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $724.44 / $1,122.02
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $676.08 / $794.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $630.96 / $1,000.00