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Arkansas 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
$161.77 / $161.77 / $161.77
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.35 / $161.77 / $161.77
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$219,999.78 / $539,999.46 / $949,999.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.25 / $332.54 / $369.49
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$292.89 / $292.89 / $340.25
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$340.25 / $340.25 / $340.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$181.86 / $181.86 / $232.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$132.76 / $181.86 / $227.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$111.88 / $143.90 / $145.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.80 / $138.72 / $195.74