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Mississippi 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
$192.03 / $192.03 / $306.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$182.86 / $219.04 / $306.05
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$265.54 / $265.54 / $265.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$265.54 / $265.54 / $265.54
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
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.26 / $162.68 / $255.18