go back

Utah 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 $575 · 10th–90th $537–$7240%20%40%10th90th$575Professionalmedian $741 · 10th–90th $417–$1,6980%10%10th90th$741$50.0$100.0$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$537.03 / $537.03 / $537.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $794.33 / $1,698.24
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $812.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $588.84 / $812.83
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $323.59 / $436.52
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $588.84 / $724.44
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $776.25
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $602.56 / $1,096.48
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $602.56 / $851.14
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $630.96 / $676.08
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $602.56 / $912.01