Lumbar-Sacral Orthosis Sagittal Control With Rigid Posterior Panel(S) Posterior Extends From Sacrococcygeal Junction To T-9 Vertebra Produces Intracavitary Pressure To Reduce Load On The Intervertebral Discs Includes Straps Closures May Include Padding Stays Shoulder Straps Pendulousabdomen Design Prefabricated 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 | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $75.05 | $549.51 | $549.51 | |
Cigna
| Facility | $112.22 | $207.52 | $207.52 | |
Cigna
| Professional | $112.22 | $207.52 | $207.52 | |
Providence
| Facility | $97.21 | $197.64 | $207.52 | |
Providence
| Professional | $153.41 | $159.19 | $207.67 | |
United
| Professional | $78.62 | $86.98 | $133.10 |