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Massachusetts 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
$478.63 / $478.63 / $478.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $616.60 / $1,513.56
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,047.13 / $1,071.52 / $6,760.83
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $851.14 / $1,122.02
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,230.27 / $1,445.44 / $1,905.46
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $741.31 / $741.31
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
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.18 / $4,897.79 / $9,772.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $954.99 / $1,479.11
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $660.69 / $660.69
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,047.13 / $1,071.52 / $6,760.83
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $851.14 / $1,230.27
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.85 / $602.56 / $1,479.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $645.65 / $954.99