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Connecticut rates for HCPCS L0490

Tlso Sagittal-Coronal Control One Piece Rigid Plastic Shell With Overlapping Reinforced Anterior With Multiple Straps And Closures Posterior Extends From Scarococcygeal Junction And Terminates At Or Before The T-9 Vertebra Anterior Extends Fromsymphysis Pubis To Xiphoid Anterior Opening Restricts Gross Trunk Motion In Sagittal And Coronal Planes Prefabricated Includes Fitting And Adjustment

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$161.69 / $161.69 / $161.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.78 / $159.01 / $162.72
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$257.83 / $332.68 / $380.62
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$185.44 / $185.44 / $194.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$227.96 / $227.96 / $227.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.41 / $166.41 / $227.96
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$216.24 / $216.24 / $216.24
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$216.24 / $216.24 / $306.07
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.63 / $245.63 / $245.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$126.66 / $165.97 / $320.38