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Arizona 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
$501.19 / $630.96 / $2,187.76
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.66 / $141.25 / $295.12
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.83 / $234.42 / $446.68
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 / $707.95
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$346.74 / $954.99 / $3,548.13
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $537.03 / $8,709.64
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.84 / $630.96 / $1,148.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $537.03 / $812.83