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Minnesota 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
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.82 / $58.82 / $346.24
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.06 / $58.82 / $58.82
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$350.00 / $350.00 / $591.50
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,790.84 / $4,790.84 / $4,790.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,790.84 / $4,790.84 / $4,790.84