Lumbar-sacral orthosis (LSO), sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to T-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, custom fabricated
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $346.74 | $346.74 | $602.56 | |
Aetna
| Professional | $346.74 | $346.74 | $346.74 | |
BCBS
| Facility | $223.87 | $281.84 | $707.95 | |
BCBS
| Professional | $218.78 | $302.00 | $398.11 | |
Cigna
| Facility | $70.79 | $70.79 | $501.19 | |
Cigna
| Professional | $144.54 | $398.11 | $1,202.26 | |
United
| Facility | $281.84 | $281.84 | $281.84 | |
United
| Professional | $4,786.30 | $4,786.30 | $4,786.30 |
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