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Nevada rates for HCPCS L0623

Sacroiliac orthosis (SO), provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.47 / $34.47 / $39.77
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.47 / $39.77 / $72.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.82 / $58.82 / $58.82
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.00 / $39.00 / $120.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.17 / $52.17 / $52.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.08 / $52.17 / $157.15
Hometown Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.17 / $60.40 / $173.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.12 / $95.03 / $156.97