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
| Professional | $350.00 | $350.00 | $350.00 | |
HMSA
| Professional | $21.15 | $22.15 | $22.15 | |
Kaiser Permanente
| Professional | $21.15 | $21.15 | $21.15 | |
United
| Professional | $4,790.84 | $4,790.84 | $4,790.84 |