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Rhode Island 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
$145.36 / $182.86 / $197.31
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$470.37 / $635.28 / $752.10
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$174.83 / $174.83 / $292.39
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 / $227.96 / $227.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.94 / $177.82 / $276.62