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 |  | With Health Insurance: Copay or 20% Coinsurance |  | Without Health Insurance: $40-$1,000 |
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A back brace[1] also known as an orthosis, is typically used to prevent or correct a deformity or to immobilize the spine after an injury or surgery. Braces may be worn on any part of the spine, with more than 30 types[2] available to treat spine disorders.
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%.
Related articles: Physical Therapy, X-Ray, Chiropractor, Spinal Decompression, Back Surgery, Health Insurance
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What should be included: | - 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.
Additional costs: | - 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.
Discounts: | - 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.
Shopping for a back brace: | - The American Board for Certification in Orthotics, Prosthetics & Pedorthics offers a free searchable database[12] of Certified Orthotists and accredited facilities for patients.
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Material on this page is for informational purposes only and should not be construed as medical advice. Always consult your physician or pharmacist regarding medications or medical procedures.
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| CostHelper News
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What People Are Paying - Recent Comments |
| Posted by: John G Frykman in Minneapolis, MN. | Posted: November 11th, 2016 09:11AM |
| Type of Back Brace: TLSO |
The Winkley Co came in to my room, measured me, and came back 2 hours later with this "TLSO." It did not fit me properly, was torture to get in and out of it, and the cost is LAUGHABLE. 2 pieces of plastic and some canvas straps with buckles. They told me my doctor (who I never met in the hospital) had prescribed it. I never agreed to buy it and have never used it. My car insurance company (no fault medical) is demanding that the company justify the bill. So far, they haven't paid for it because Winkley has not complied with their request for documentation. Total rip-off. |
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| Posted by: Gregory Turner in Houston, TX. | Posted: June 16th, 2015 12:06PM |
| Type of Back Brace: Miam Lso w/lateral post panel, standard |
I wasn't advised on the cost or coverage by my ins. carrier it was issued to my wife in the hospital. My ins. carrier said they did not have a contract with Dura Medic and that it was out of network. The cost is utterly rediculous in my opinion. |
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External Resources: | - www.mayfieldclinic.com/PE-brace.htm
- www.umm.edu/spinecenter/education/back_and_neck_braces.htm
- www.mmarmedical.com/Aspen_QuikDraw_p/99xx.htm
- orthopedic-products.medical-supplies-equipment-company.com/product/criss-cross-lumbosac...
- /cignaforhcp.cigna.com/public/content/pdf/coveragePolicies/medical/mm_0394_coverageposi...
- www.geisinger.org/services/orthopaedics/orthotics/index.html
- nyp.org/health/pmr_orthpros.html
- emedicine.medscape.com/article/314921-overview#a17
- www.sjo.org/For-Patients/Your-Hospital-Bill/Self-Pay-Discount-Program.aspx
- www.communityhfc.org/referals.htm
- findahealthcenter.hrsa.gov/Search_HCC.aspx
- oandpcare.org/Search
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