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Pennsylvania 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 $1,549 · 10th–90th $398–$4,0740%20%10th90th$1,549Professionalmedian $617 · 10th–90th $398–$1,0230%10%20%10th90th$617$1.0$10.0$100.0$1.0K$10.0K

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
$398.11 / $1,548.82 / $4,073.80
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $602.56 / $1,023.29
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $831.76 / $831.76
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $588.84 / $794.33
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $794.33
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 / $588.84 / $870.96
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $1,071.52 / $1,548.82
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $812.83
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $562.34 / $812.83
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $630.96 / $851.14
Independence Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $588.84 / $588.84
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $398.11
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $562.34 / $912.01
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $501.19 / $1,905.46
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $912.01 / $912.01
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $870.96 / $933.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $1,445.44 / $1,659.59
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $645.65 / $1,096.48