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Washington 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 $776 · 10th–90th $389–$2,1880%10%10th90th$776Professionalmedian $631 · 10th–90th $347–$1,5140%10%10th90th$631$10.0$50.0$200.0$1.0K$5.0K

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
$457.09 / $457.09 / $1,071.52
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $724.44 / $1,288.25
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $891.25 / $891.25
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $380.19 / $1,096.48
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $363.08 / $954.99
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 / $812.83
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $1,348.96 / $2,818.38
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $1,122.02 / $2,187.76
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,023.29 / $1,122.02
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $1,071.52
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $588.84 / $588.84
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $588.84 / $954.99
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $323.59 / $575.44
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $380.19 / $602.56
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $407.38 / $954.99
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $1,737.80 / $1,737.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $630.96 / $1,047.13
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $346.74 / $954.99