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Alabama rates for HCPCS L0626

Lumbar Orthosis Sagittal Control With Rigid Posterior Panel(S) Posterior Extends From L-1 To L-5 Vertebra Produces Intracavitary Pressure To Reduce Load On The Intervertebral Discs Includes Straps Closures May Include Padding Stays Shoulder Straps Pendulous Abdomen Design Pre- Fabricated Item That Has Been Trimmed Bent Molded Assembled Or Otherwise Customized To Fit A Specific Patient By An Individual With Expertise(Revised 01/01/14)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.17 / $85.17 / $85.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.32 / $60.36 / $85.17
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.67 / $62.67 / $62.67
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.60 / $58.60 / $93.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.78 / $58.60 / $92.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.91 / $41.86 / $64.86