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Alaska 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
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $741.31 / $1,698.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$707.95 / $707.95 / $707.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $524.81 / $741.31
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$346.74 / $1,096.48 / $1,905.46
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $1,905.46 / $3,801.89
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,096.48 / $1,905.46 / $1,995.26
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,548.82 / $1,905.46 / $1,949.84
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$346.74 / $346.74 / $1,479.11
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $707.95 / $1,174.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$537.03 / $537.03 / $616.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $1,479.11 / $4,897.79