go back

Mississippi rates for HCPCS L0634

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
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
Professional
Modifier
Low / Median / High Price
$269.19 / $269.19 / $269.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.11 / $144.11 / $144.11
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.00 / $21.25 / $50.00