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Nationwide rates for HCPCS L0635

Lumbar-sacral orthosis (LSO), sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, 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, anterior panel, pendulous abdomen design, prefabricated, includes fitting and adjustment

Insurance Carrier	Facility/Professional	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $630.96 / $1,230.27	Facility	$446.68	$630.96	$1,230.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $630.96 / $1,122.02	Professional	$489.78	$630.96	$1,122.02
BCBS Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $676.08 / $2,570.40	Facility	$489.78	$676.08	$2,570.40
BCBS Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $660.69 / $1,445.44	Professional	$630.96	$660.69	$1,445.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $707.95 / $5,011.87	Facility	$707.95	$707.95	$5,011.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $524.81 / $1,737.80	Professional	$524.81	$524.81	$1,737.80
United Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $645.65 / $1,479.11	Facility	$407.38	$645.65	$1,479.11
United Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $588.84 / $912.01	Professional	$416.87	$588.84	$912.01

Nationwide rates for HCPCS L0635

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