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Oregon 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
Professional
Modifier
Low / Median / High Price
$146.30 / $199.56 / $959.87
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
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$232.88 / $644.87 / $841.09
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$199.56 / $273.39 / $332.68
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$247.36 / $312.72 / $349.31
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$264.06 / $332.68 / $365.95
Pacific Source
Facility/Professional
Professional
Modifier
Low / Median / High Price
$299.41 / $332.68 / $344.54
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$199.56 / $285.37 / $349.31
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.41 / $291.31 / $365.95
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$277.17 / $553.24 / $1,167.16
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$286.10 / $365.95 / $365.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$142.97 / $151.90 / $289.80