Lumbar-sacral orthosis (LSO), sagittal control, with rigid anterior and posterior panels, 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, shoulder straps, pendulous abdomen design, custom fabricated
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $44.67 | $44.67 | $44.67 | |
Aetna
| Professional | $44.67 | $44.67 | $44.67 | |
Cigna
| Facility | $380.19 | $380.19 | $380.19 | |
Cigna
| Professional | $275.42 | $380.19 | $380.19 | |
Medica
| Facility | $44.67 | $79.43 | $89.13 | |
Medica
| Professional | $44.67 | $44.67 | $44.67 |