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Iowa rates for HCPCS L0634

Lumbar-Sacral Orthosis 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
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$350.00 / $350.00 / $350.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$350.00 / $350.00 / $350.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$626.86 / $720.59 / $854.31
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$774.35 / $796.39 / $851.87
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$350.00 / $514.79 / $768.04
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$604.22 / $720.59 / $2,757.30
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$720.59 / $720.59 / $720.59
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$626.86 / $626.86 / $720.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,757.30 / $2,757.30 / $2,757.30
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$600.00 / $600.00 / $600.00
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$474.00 / $600.00 / $600.00