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Rhode Island 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
Professional
Modifier
Low / Median / High Price
$169.55 / $174.80 / $230.16
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$548.66 / $741.03 / $877.29
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$185.73 / $218.51 / $350.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$181.86 / $181.86 / $181.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$132.76 / $181.86 / $181.86
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$143.90 / $143.90 / $143.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.84 / $193.60 / $322.66