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Kansas 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
Facility
Modifier
Low / Median / High Price
$933.25 / $933.25 / $933.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $645.65 / $933.25
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$912.01 / $954.99 / $1,023.29
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,071.52 / $1,071.52
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 / $1,380.38
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$346.74 / $870.96 / $2,884.03
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $602.56 / $8,709.64
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$416.87 / $954.99 / $954.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $575.44 / $812.83