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Vermont 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
$162.34 / $162.34 / $187.32
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$227.96 / $227.96 / $244.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.41 / $189.78 / $234.80
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$227.96 / $227.96 / $244.51
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.41 / $227.96 / $234.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.65 / $250.01 / $276.62