go back

Rhode Island 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
Professional
Modifier
Low / Median / High Price
$27.84 / $50.39 / $54.36
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$129.59 / $175.01 / $207.19
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.86 / $59.86 / $82.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.60 / $58.60 / $58.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.78 / $58.60 / $58.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.47 / $45.73 / $76.20