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Maryland 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
$436.52 / $616.60 / $1,122.02
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $602.56 / $758.58
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
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $1,096.48 / $1,659.59
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$363.08 / $524.81 / $812.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $537.03 / $851.14
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $645.65 / $912.01