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 | $245.00 | $350.00 | $350.00 | |
Aetna
| Professional | $245.00 | $350.00 | $350.00 | |
Florida Blue
| Facility | $99,999.99 | $99,999.99 | $99,999.99 | |
Florida Blue
| Professional | $450.00 | $99,999.99 | $99,999.99 | |
Molina
| Professional | $40.00 | $40.00 | $50.00 | |
Wellpoint
| Professional | $301.30 | $301.30 | $301.30 |