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Alabama rates for HCPCS L0622

Sacroiliac Orthosis Flexible Provides Pelvic-Sacral Support Reduces Motion About The Sacroiliac Joint Includes Straps Closures May Include Pendulous Abdomen Design Custom Fabricated

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$264.17 / $264.17 / $264.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.05 / $264.17 / $264.17
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.01 / $218.01 / $218.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$181.86 / $181.86 / $322.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$132.76 / $181.86 / $286.04
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$98.42 / $143.90 / $172.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.80 / $143.90 / $218.72