Back Brace Cost

Typical costs:

• For uninsured patients, back braces typically range in cost from $40 - $1,000, depending on the type of material, the size and style, and whether the device is prefabricated, custom-fitted, or custom-made. For example, the Aspen QuikDraw[3] , a brace that allows patients to control and adjust compression, costs $250, while the relatively simple Criss Cross Lumbosacral Supports[4] elastic brace costs about $38.
• Most traditional health insurers cover back braces if the devices meet the criteria for durable medical equipment and are deemed medically necessary. Depending on the plan, there may also be additional restrictions. For instance, Cigna[5] stipulates that unmodified, pre-fabricated braces must be considered first, over custom-fitted or custom-fabricated models. Other insurers may not cover the cost of a new brace if a patient has already been given one within the past few years, or may require that the brace be purchased from a specific supplier.
• For insured patients, out-of-pocket costs typically consist of a medical device copay or coinsurance of about 20%.

• According to a patient guide[6] offered by Geisinger Medical Center in Danville, PA, a qualified clinician known as an orthotist[7] , will evaluate and measure the patient for the prescribed orthosis. The device is then fit to the patient, with any necessary re-contouring or modifications made.
• The patient will be instructed on proper use and care for the device, which must be observed to decrease potential complications[8] .
• If a custom-made back brace is required, an orthotist will need to work closely with the physician and physical therapist to formulate a prescription and then design, fabricate, and fit the orthosis.

• If physical therapy is needed, it could add hundreds of dollars to the final bill. Per session, physical therapy typically costs $50- $350 for uninsured patients, or brings a copay of $10 -$75 for insured patients.
• In order to measure progress, the patient may also need to make several follow up visits and take X-Rays to see if the bone has healed enough to discontinue use of the brace.

• Many hospitals offer discounts of 30% or more to uninsured/cash-paying patients. At St. Joseph Hospital[9] in Orange, CA, for example, patients without health insurance may qualify for a 45% discount off billed charges. They'll also be offered an additional 10% discount if payment is made within 10 days of receiving a bill.
• Some free clinics, such as Community Health Free Clinic[10] in Chicago, provide orthopedic or neurological specialty care. The U.S. Department of Health and Human Services[11] posts a directory of federally funded health centers; if the nearest clinic doesn't offer orthopedic care, ask for a referral.

• The American Board for Certification in Orthotics, Prosthetics & Pedorthics offers a free searchable database[12] of Certified Orthotists and accredited facilities for patients.

1.  www.mayfieldclinic.com/PE-brace.htm
2.  www.umm.edu/spinecenter/education/back_and_neck_braces.htm
3.  www.mmarmedical.com/Aspen_QuikDraw_p/99xx.htm
4.  orthopedic-products.medical-supplies-equipment-company.com/product/criss-cross-lum...
5.  /cignaforhcp.cigna.com/public/content/pdf/coveragePolicies/medical/mm_0394_coverag...
6.  www.geisinger.org/services/orthopaedics/orthotics/index.html
7.  nyp.org/health/pmr_orthpros.html
8.  emedicine.medscape.com/article/314921-overview#a17
9.  www.sjo.org/For-Patients/Your-Hospital-Bill/Self-Pay-Discount-Program.aspx
10.  www.communityhfc.org/referals.htm
11.  findahealthcenter.hrsa.gov/Search_HCC.aspx
12.  oandpcare.org/Search

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