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Washington, DC 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
$136.16 / $136.16 / $136.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.16 / $136.16 / $136.16
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$291.31 / $291.31 / $291.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.41 / $166.41 / $166.41
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$216.24 / $216.24 / $660.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.65 / $165.97 / $249.37