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Virginia 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 $933 · 10th–90th $550–$1,2880%20%40%10th90th$933Professionalmedian $741 · 10th–90th $468–$1,2300%20%10th90th$741$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
$380.19 / $630.96 / $1,148.15
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $630.96 / $1,047.13
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $933.25 / $977.24
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $741.31 / $1,548.82
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $831.76 / $831.76
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$537.03 / $812.83 / $812.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $588.84 / $812.83
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $954.99 / $1,412.54
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $758.58 / $1,258.93
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $776.25 / $1,148.15
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $1,000.00 / $1,698.24
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $1,000.00 / $1,698.24
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $645.65 / $1,445.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $630.96 / $1,047.13